Dataset Information

A randomized controlled trial to investigate the use of acute coronary syndrome therapy in patients hospitalized with COVID-19: the COVID-19 Acute Coronary Syndrome trial.

ABSTRACT:

Background

Patients hospitalized with COVID-19 suffer thrombotic complications. Risk factors for poor outcomes are shared with coronary artery disease.

Objectives

To investigate the efficacy of an acute coronary syndrome regimen in patients hospitalized with COVID-19 and coronary disease risk factors.

Methods

A randomized controlled, open-label trial across acute hospitals (United Kingdom and Brazil) added aspirin, clopidogrel, low-dose rivaroxaban, atorvastatin, and omeprazole to standard care for 28 days. Primary efficacy and safety outcomes were 30-day mortality and bleeding. The key secondary outcome was a daily clinical status (at home, in hospital, on intensive therapy unit admission, or death).

Results

Three hundred twenty patients from 9 centers were randomized. The trial terminated early due to low recruitment. At 30 days, there was no significant difference in mortality (intervention vs control, 11.5% vs 15%; unadjusted odds ratio [OR], 0.73; 95% CI, 0.38-1.41; p = .355). Significant bleeds were infrequent and were not significantly different between the arms (intervention vs control, 1.9% vs 1.9%; p > .999). Using a Bayesian Markov longitudinal ordinal model, it was 93% probable that intervention arm participants were more likely to transition to a better clinical state each day (OR, 1.46; 95% credible interval [CrI], 0.88-2.37; Pr [beta > 0], 93%; adjusted OR, 1.50; 95% CrI, 0.91-2.45; Pr [beta > 0], 95%) and median time to discharge to home was 2 days shorter (95% CrI, -4 to 0; 2% probability that it was worse).

Conclusion

Acute coronary syndrome treatment regimen was associated with a reduction in the length of hospital stay without an excess in major bleeding. A larger trial is needed to evaluate mortality.

SUBMITTER: Kanagaratnam P

PROVIDER: S-EPMC10204350 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

A randomized controlled trial to investigate the use of acute coronary syndrome therapy in patients hospitalized with COVID-19: the COVID-19 Acute Coronary Syndrome trial.

Kanagaratnam Prapa P Francis Darrel P DP Chamie Daniel D Coyle Clare C Marynina Alena A Katritsis George G Paiva Patricia P Szigeti Matyas M Cole Graham G de Andrade Nunes David D Howard James J Esper Rodrigo R Khan Masood M More Ranjit R Barreto Guilherme G Meneguz-Moreno Rafael R Arnold Ahran A Nowbar Alexandra A Kaura Amit A Mariveles Myril M March Katherine K Shah Jaymin J Nijjer Sukhjinder S Lip Gregory Y H GYH Mills Nicholas N Camm A John AJ Cooke Graham S GS Corbett Simon J SJ Llewelyn Martin J MJ Ghanima Waleed W Toshner Mark M Peters Nicholas N Petraco Ricardo R Al-Lamee Rasha R Boshoff Ana Sousa Marcelino ASM Durkina Margarita M Malik Iqbal I Ruparelia Neil N Cornelius Victoria V Shun-Shin Matthew M

Journal of thrombosis and haemostasis : JTH 20230523 8

<h4>Background</h4>Patients hospitalized with COVID-19 suffer thrombotic complications. Risk factors for poor outcomes are shared with coronary artery disease.<h4>Objectives</h4>To investigate the efficacy of an acute coronary syndrome regimen in patients hospitalized with COVID-19 and coronary disease risk factors.<h4>Methods</h4>A randomized controlled, open-label trial across acute hospitals (United Kingdom and Brazil) added aspirin, clopidogrel, low-dose rivaroxaban, atorvastatin, and omepra ...[more]

PMID: 37230416

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Dataset Information

A randomized controlled trial to investigate the use of acute coronary syndrome therapy in patients hospitalized with COVID-19: the COVID-19 Acute Coronary Syndrome trial.

Background

Objectives

Methods

Results

Conclusion

Publications

A randomized controlled trial to investigate the use of acute coronary syndrome therapy in patients hospitalized with COVID-19: the COVID-19 Acute Coronary Syndrome trial.

Similar Datasets

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