RT Journal Article
SR Electronic
T1 Antiplatelet therapy and outcome in COVID-19: the Health Outcome Predictive Evaluation Registry
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 130
OP 136
DO 10.1136/heartjnl-2021-319552
VO 108
IS 2
A1 Francesco Santoro
A1 Ivan Javier Nuñez-Gil
A1 Enrica Vitale
A1 Maria C Viana-Llamas
A1 Begoña Reche-Martinez
A1 Rodolfo Romero-Pareja
A1 Gisela Feltez Guzman
A1 Inmaculada Fernandez Rozas
A1 Aitor Uribarri
A1 Víctor Manuel Becerra-Muñoz
A1 Emilio Alfonso-Rodriguez
A1 Marcos Garcia-Aguado
A1 Jia Huang
A1 María Elizabeth Ortega-Armas
A1 Juan F Garcia Prieto
A1 Eva Maria Corral Rubio
A1 Fabrizio Ugo
A1 Matteo Bianco
A1 Alba Mulet
A1 Sergio Raposeiras-Roubin
A1 Jorge Luis Jativa Mendez
A1 Carolina Espejo Paeres
A1 Adrián Rodríguez Albarrán
A1 Francisco Marín
A1 Federico Guerra
A1 Ibrahim Akin
A1 Bernardo Cortese
A1 Harish Ramakrishna
A1 Carlos Macaya
A1 Antonio Fernandez-Ortiz
A1 Natale Daniele Brunetti
YR 2022
UL http://heart.bmj.com/content/108/2/130.abstract
AB Background Standard therapy for COVID-19 is continuously evolving. Autopsy studies showed high prevalence of platelet-fibrin-rich microthrombi in several organs. The aim of the study was therefore to evaluate the safety and efficacy of antiplatelet therapy (APT) in hospitalised patients with COVID-19 and its impact on survival.Methods 7824 consecutive patients with COVID-19 were enrolled in a multicentre international prospective registry (Health Outcome Predictive Evaluation-COVID-19 Registry). Clinical data and in-hospital complications were recorded. Data on APT, including aspirin and other antiplatelet drugs, were obtained for each patient.Results During hospitalisation, 730 (9%) patients received single APT (93%, n=680) or dual APT (7%, n=50). Patients treated with APT were older (74±12 years vs 63±17 years, p<0.01), more frequently male (68% vs 57%, p<0.01) and had higher prevalence of diabetes (39% vs 16%, p<0.01). Patients treated with APT showed no differences in terms of in-hospital mortality (18% vs 19%, p=0.64), need for invasive ventilation (8.7% vs 8.5%, p=0.88), embolic events (2.9% vs 2.5% p=0.34) and bleeding (2.1% vs 2.4%, p=0.43), but had shorter duration of mechanical ventilation (8±5 days vs 11±7 days, p=0.01); however, when comparing patients with APT versus no APT and no anticoagulation therapy, APT was associated with lower mortality rates (log-rank p<0.01, relative risk 0.79, 95% CI 0.70 to 0.94). On multivariable analysis, in-hospital APT was associated with lower mortality risk (relative risk 0.39, 95% CI 0.32 to 0.48, p<0.01).Conclusions APT during hospitalisation for COVID-19 could be associated with lower mortality risk and shorter duration of mechanical ventilation, without increased risk of bleeding.Trial registration number NCT04334291.Data are available upon reasonable request.