Real-World Management of Pharmacological Thromboprophylactic Strategies for COVID-19 Patients in Japan

Hayashi, Hiroya; Izumiya, Yasuhiro; Fukuda, Daiju; Wakita, Fumiaki; Mizobata, Yasumitsu; Fujii, Hiromichi; Yachi, Sen; Takeyama, Makoto; Nishimoto, Yuji; Tsujino, Ichizo; Nakamura, Junichi; Yamamoto, Naoto; Nakata, Hiroko; Ikeda, Satoshi; Umetsu, Michihisa; Aikawa, Shizu; Satokawa, Hirono; Okuno, Yoshinori; Iwata, Eriko; Ogihara, Yoshito; Ikeda, Nobutaka; Kondo, Akane; Iwai, Takehisa; Yamada, Norikazu; Ogawa, Tomohiro; Kobayashi, Takao; Mo, Makoto; Yamashita, Yugo

doi:10.1016/j.jacasi.2022.09.005

Cited by 6 publications

(4 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The international guidelines suggest D-dimer values as a criterion for anticoagulation therapy; however, in real-world practice in Japan, the use of anticoagulation therapy is often left to the judgment of the physician in charge of each case while considering comorbidities and the disease status ( 25 ). Although further large-scale studies on FMC in COVID-19 are needed, the increase in the FMC levels may be an adjunctive indicator of anticoagulation, as is currently the case with D-dimer.…”

Section: Discussionmentioning

confidence: 99%

Role of Fibrin Monomer Complex in Coronavirus Disease 2019 for Venous Thromboembolism and the Prognosis

Kawame,

Kasai,

Shiohira

et al. 2023

Intern. Med.

View full text Add to dashboard Cite

Objective Venous thromboembolism (VTE) is a common complication of severe coronavirus disease 2019 (COVID-19) and is associated with its prognosis. The fibrin monomer complex (FMC), a marker of thrombin generation, is reportedly useful in diagnosing acute thrombosis. To date, there has been only one report on FMC in COVID-19, and the usefulness of FMC in COVID-19 is unknown. We therefore evaluated the frequency of VTE in non-intensive-care unit COVID-19 patients in Japan and determine the clinical utility of FMC in COVID-19. Methods This was a single-center retrospective study. Laboratory test results and outcomes (thrombosis and severe progression of COVID-19) were obtained via medical record review. We assessed the relationship between FMC and VTE incidence and evaluated the association between elevated FMC levels and severe progression of COVID-19. Patients This study included 247 patients with COVID-19 who were hospitalized between December 2020 and September 2021 and had had their levels of D-dimer and FMC measured. Results Of the 247 included patients, 3 (1.2%) developed VTE. All three had elevated FMC levels on admission; however, the D-dimer level was not elevated in one case on admission. The FMC level was significantly higher in the group with severe COVID-19 progression than in the group without severe progression. A multivariate analysis showed that severe progression was associated with elevated FMC levels (odds ratio, 7.40; 95% confidence interval, 2.63-22.98; p＜0.001). Conclusion FMC can be useful for diagnosing VTE in the acute phase of COVID-19. Elevated FMC was found to be associated with severity on admission and severe progression.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of Fibrin Monomer Complex in Coronavirus Disease 2019 for Venous Thromboembolism and the Prognosis

Kawame,

Kasai,

Shiohira

et al. 2023

Intern. Med.

View full text Add to dashboard Cite

show abstract

“…The CLOT-COVID-19 study also investigated the real-world anticoagulation strategies for COVID-19 patients in Japan, which demonstrated that 43% of hospitalized patients with COVID-19 underwent pharmacological thromboprophylaxis, and the proportion of pharmacological thromboprophylaxis increased according to COVID-19 severity in 9.8% with mild COVID-19, 61% with moderate COVID-19, and 97% with severe COVID-19; moreover, the types and doses of anticoagulants widely varied across the participating centers 53) . Pharmacological thromboprophylaxis, using anticoagulants at therapeutic doses, was reported to be selectively implemented in COVID-19 patients with comorbidities and severe COVID-19 status at admission 54) . The proportion of hospitalized patients with COVID-19 who underwent pharmacological thromboprophylaxis was substantially higher in this study than in the previous ones from the first and second waves of COVID-19 in Japan 55,56) .…”

Section: Anticoagulation Strategies In Japanmentioning

confidence: 99%

Thrombosis and Anticoagulation Strategies in Patients with COVID-19 Including Japanese Perspective

Yamashita

Kobayashi

2023

JAT

Self Cite

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19) has become a major health problem worldwide since 2020.Although the main pathophysiology of COVID-19 is a respiratory infectious disease, it could also cause cardiovascular complications, including thrombosis. Thus, anticoagulation therapy has been thought to help prevent thrombosis, leading to improved survival. However, to date, several aspects of the optimal anticoagulation strategies for COVID-19 remain unclear. Considering the status of COVID-19-related thrombosis and some domestic issues in Japan, the optimal anticoagulation strategies for COVID-19 might have to be based on Japanese domestic clinical data considering racial difference. Racial disparities in terms of thromboembolic risk have been well known in the pre-COVID-19 era, and the risk of COVID-19-associated thrombosis depending on race could be an important issue. Considering a potential higher risk of bleeding with anticoagulation therapy in the Asian population, it might be important to maintain a good balance between the risks of thrombosis and bleeding. Latest evidences of COVID-19-related thrombosis and anticoagulation strategies, including some domestic issues in Japan, showed a different status of COVID-19-related thrombosis in Japan from that in Western countries, suggesting the potential benefit of different anticoagulation strategies, specifically for the Japanese population. Although these insights could be useful for the consideration of anticoagulation strategies for the Japanese population, the final decision should be based on balancing the benefits and risks of anticoagulation therapy in each patient.

show abstract

“…For example, The Thrombosis and Anticoagulation Therapy in Patients With COVID-19 (CLOT-COVID) registry, which included Japanese patients with COVID-19 infection, showed that only 1.87% of the total cohort had documented thrombotic events (n=54 out of 2,894) in the early phase of COVID-19 pandemic. 9) Meanwhile, a recent meta-analysis, which predominantly included hospitalized Western patients with COVID-19 infection, reported VTEs in 14.7% of cases and ATEs in 7.8% of cases, respectively. 2) …”

mentioning

confidence: 99%

Type 2 Myocardial Infarction: Another Hidden Cause of Mortality During the COVID-19 Pandemic

Cho,

Byeon,

Jeong

2023

Korean Circ J

View full text Add to dashboard Cite

Real-World Management of Pharmacological Thromboprophylactic Strategies for COVID-19 Patients in Japan

Cited by 6 publications

References 39 publications

Role of Fibrin Monomer Complex in Coronavirus Disease 2019 for Venous Thromboembolism and the Prognosis

Role of Fibrin Monomer Complex in Coronavirus Disease 2019 for Venous Thromboembolism and the Prognosis

Thrombosis and Anticoagulation Strategies in Patients with COVID-19 Including Japanese Perspective

Type 2 Myocardial Infarction: Another Hidden Cause of Mortality During the COVID-19 Pandemic

Contact Info

Product

Resources

About