What’s Hot in Clots – July 2024

Key Updates in Thrombosis

Table of Contents

1. The fall of aspirin?
2. Clots in the pulmonary circulation –what an interesting review!
3. The risk of recurrent events after discontinuing anticoagulation for COVID-19-associated VTE
4. Extended DAPT after CABG?

One of –the many –advantages of living in the Northeast is that even when I’m writing What’s Hot in Clots in late June, it’s only 23 degrees, Celsius (well, my brain still functions that way –it’s 70F). Here we go:

The fall of aspirin?

Well, that’s an overstatement. I still see a lot of value for the old drug in many situations. That said, a recent study suggests small but meaningful declines in utilization of aspirin in the US in recent years. Read more

Clots in the pulmonary circulation –what an interesting review!

Wouldn’t torture you with calling a traditional PE review so interesting! This one is special because it covers pulmonary vein thrombosis. Keep cancer, surgery, and extrinsic compression in mind. Read more

The risk of recurrent events after discontinuing anticoagulation for COVID-19-associated VTE

In a nutshell, the risk is –thankfully –low. In this multicenter study based on RIETE, the recurrence rate was 3.1 per 100 patient-years of follow-up, which is fairly similar to those developed after other major provoking factors. This is reassuring and indicates that most patients who do not have plenty of enduring risk factors may safely consider discontinuation. Read more

Extended DAPT after CABG?

I started asking myself whether I should keep the “extended DAPT” stem and replace it with something every month. Really! Last month –and some other times –I tied about the “less is more” approach, of monotherapy being better than DAPT in certain scenarios. Guess what? Now is the time for “more is more”! Long-term follow-up results from the DACAB RCT suggest lower MACE with continued DAPT, compared with monotherapy. There is no one-size-fits-all, but this is among the subgroups in whom I would have a higher threshold to de-escalate DAPT. Read more

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