Thrombosis and Haemostasis
Author Interview
Stroke, Systemic or Venous Thromboembolism
Thromb Haemost 2022; 122(01): 131-141
DOI: 10.1055/a-1485-2372
T&H
Why did you (and your colleagues) write this paper? What was its main purpose?
BEHNOOD BIKDELI
Since early weeks of the pandemic, many clinicians and investigators have been concerned that adverse events, including death and thrombotic events may accrue over a period of weeks (not just days) in patients with COVID-19. Therefore, we had prespecified to assess the outcomes may accrue over a period of weeks (not just days) in patients with COVID-19. Therefore, we had prespecified to assess the outcomes in participants of the INSPIRATION trial at 90-day follow-up.
T&H
What are the main conclusions?
BEHNOOD BIKDELI
In the INSPIRATION randomized trial, we previously showed that intermediate-dose, compared with standard-dose, prophylactic anticoagulation, did not result in reduction of a composite of 30-day mortality or thrombotic events. In the current manuscript, we extend those findings by sharing new 90-day analyses, including landmark analyses for mortality from days 31-90. The study showed that beyond the first 30 days there were very few additional efficacy (and safety) events.
T&H
What are the paper's implications? - to the public? -to medical professionals?
BEHNOOD BIKDELI
I think these results, along with a series of other recent studies indicate that perhaps thrombotic events and mortality in the post-discharge state for patients with COVID-19 are a little less common than originally anticipated. While we remain cognizant and excited to see the findings from ongoing randomized trials, our analyses and others may dampen the enthusiasm for empiric escalated-dose anticoagulation merely for COVID-19.
T&H
Are the findings clinically significant? Should the findings change practice?
BEHNOOD BIKDELI
I believe so. I would love to see follow-up results of other ongoing trials, as well. And it is important to note that a few trials are particularly recruiting patients in the post-discharge setting. It is my hope that over the next 3 months we can move from consensus-based recommendations toward evidence-based recommendations.
