Pre- and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes. Issue 4 (3rd April 2022)

• Record Type: Journal Article
• Authors: Battistoni, Ilaria; Francioni, Matteo; Morici, Nuccia; Rubboli, Andrea; Podda, Gian Marco; Pappalardo, Andrea; Abdelrahim, Mohamed E.A.; Elgendy, Marwa O.; Elgendy, Sara O.; 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 A.;
• Is Part Of: Journal of cardiovascular medicine. Volume 23:Issue 4(2022)
• Page Start: 264
• Page End: 271
• Publication Date: 2022-04-03
• Subjects: chronic anticoagulant therapy -- coronavirus disease 2019 -- heparin -- hospital outcomes -- Low Molecular Weight Heparin -- SARS- coronavirus 2; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000001284
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : 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.