Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: https://twitter.com/AzitaTalasaz.
Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Am Coll Cardiol. 2021 Apr 20;77(15):1903-1921. doi: 10.1016/j.jacc.2021.02.035. Epub 2021 Mar 16.
Endothelial injury and microvascular/macrovascular thrombosis are common pathophysiological features of coronavirus disease-2019 (COVID-19). However, the optimal thromboprophylactic regimens remain unknown across the spectrum of illness severity of COVID-19. A variety of antithrombotic agents, doses, and durations of therapy are being assessed in ongoing randomized controlled trials (RCTs) that focus on outpatients, hospitalized patients in medical wards, and patients critically ill with COVID-19. This paper provides a perspective of the ongoing or completed RCTs related to antithrombotic strategies used in COVID-19, the opportunities and challenges for the clinical trial enterprise, and areas of existing knowledge, as well as data gaps that may motivate the design of future RCTs.
内皮损伤和微血管/大血管血栓形成是 2019 年冠状病毒病(COVID-19)的常见病理生理特征。然而,在 COVID-19 疾病严重程度的各个阶段,最佳的血栓预防方案仍不清楚。目前正在进行的随机对照试验(RCT)正在评估各种抗血栓药物、剂量和治疗持续时间,这些试验侧重于门诊患者、住院内科患者和 COVID-19 重症患者。本文提供了一个视角,介绍了与 COVID-19 中使用的抗血栓策略相关的正在进行或已完成的 RCT,临床试验企业的机遇和挑战,以及现有知识领域以及可能激发未来 RCT 设计的数据空白。