Naslov
Pre- and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity- matched analysis of in-hospital outcomes

Autori
Battistoni, Ilaria ; Francioni, Matteo ; Morici, Nuccia ; Rubboli, Andrea ; Podda, Gian Marco ; Pappalardo, Andrea ; Abdelrahim, Mohamed E.A. ; El Gendy, Osama S. ; Khalaf, Ahmed M. ; Hamied, Ahmed Abdel M. ; Garcés, Héctor Hernández ; Abdelhamid, Omar E.S. ; Tawfik, Karim A.M. ; Zeduri, Anna ; Bassi, Gabriele ; Pongetti, Giulia ; Angelini, Luca ; Giovinazzo, Stefano ; Garcia, Pablo Martinez ; Serino, Francesco Saverio ; Polistina, Giorgio Emanuele ; Fiorentino, Giuseppe ; Barbati, Giovanni ; Toniolo, Anna ; Fabbrizioli, Azzurra ; Belenguer-Muncharaz, Alberto ; Porto, Italo ; Ocak, Sibel ; Minuz, Pietro ; Bernal, Francisco ; Hermosilla, Irina ; Borovac, Josip Anđelo

Izvornik
Journal of cardiovascular medicine (1558-2027) 23 (2022), 4; 264-271

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
chronic anticoagulant therapy ; coronavirus disease 2019 ; COVID-19 ; heparin, hospital outcomes, low molecular weight heparin (LMWH), SARS-COV-2 ; coronavirus 2 ; bleeding ; death ; propensity score matching ; PMS ; analysis

Sažetak
Aims: To estimate if chronic anticoagulant (CAC) treatment is associated with morbidity and mortality outcomes of patients hospitalized for SARS-CoV-2 infection. Methods: In this European multicentric cohort study, we included 1186 patients of whom 144 were on CAC (12.1%) with positive coronavirus disease 2019 testing between 1 February and 30 July 2020. The average treatment effect (ATE) analysis with a propensity score- matching (PSM) algorithm was used to estimate the impact of CAC on the primary outcomes defined as in-hospital death, major and minor bleeding events, cardiovascular complications (CCI), and acute kidney injury (AKI). We also investigated if different dosages of in-hospital heparin were associated with in- hospital survival. Results: In unadjusted populations, primary outcomes were significantly higher among CAC patients compared with non-CAC patients: all-cause death (35% vs. 18% P < 0.001), major and minor bleeding (14% vs. 8% P = 0.026 ; 25% vs. 17% P = 0.014), CCI (27% vs. 14% P < 0.001), and AKI (42% vs. 19% P < 0.001). In ATE analysis with PSM, there was no significant association between CAC and primary outcomes except for an increased incidence of AKI (ATE +10.2%, 95% confidence interval 0.3-20.1%, P = 0.044). Conversely, in- hospital heparin, regardless of dose, was associated with a significantly higher survival compared with no anticoagulation. Conclusions: The use of CAC was not associated with the primary outcomes except for the increase in AKI. However, in the adjusted survival analysis, any dose of in-hospital anticoagulation was associated with significantly higher survival compared with no anticoagulation.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA