Recent Randomized Trials of Antithrombotic Therapy for Patients With COVID-19

JACC State-of-the-Art Review

Azita H. Talasaz, PHARMD; Parham Sadeghipour, MD; Hessam Kakavand, PHARMD; Maryam Aghakouchakzadeh, PHARMD; Elaheh Kordzadeh-Kermani, PHARMD; Benjamin W. Van Tassell, PHARMD; Azin Gheymati, PHARMD; Hamid Ariannejad, MD; Seyed Hossein Hosseini, PHARMD; Sepehr Jamalkhani; Michelle Sholzberg, MDCM, MSC; Manuel Monreal, MD, PHD; David Jimenez, MD, PHD; Gregory Piazza, MD, MS; Sahil A. Parikh, MD; Ajay J. Kirtane, MD, SM; John W. Eikelboom, MBBS; Jean M. Connors, MD; Beverley J. Hunt, MD; Stavros V. Konstantinides, MD, PHD; Mary Cushman, MD, MSC; Jeffrey I. Weitz, MD; Gregg W. Stone, MD; Harlan M. Krumholz, MD, SM; Gregory Y.H. Lip, MD; Samuel Z. Goldhaber, MD; Behnood Bikdeli, MD, MS

Disclosures

J Am Coll Cardiol. 2021;77(15):1903-1921. 

In This Article

Abstract and Introduction

Abstract

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.

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