Cost-effectiveness of rivaroxaban plus aspirin (dual pathway inhibition) for prevention of ischaemic events in patients with cardiovascular disease: on top optimisation of secondary prevention medication in the context of COVID-19 pandemia

Multidisciplinary Approach to the Diagnosis and In-Hospital Management of COVID-19 Infection: A Narrative Review

“…In acute myocardial infarction NSTEMI, cardiac CT should be considered for risk stratification in patients at intermediate and low risk. In patients with chronic coronary syndrome, aspirin should not be stopped because of its anti-inflammatory effect ( Rauch, 2020 ). Statin therapy may be interrupted considering the elevated liver enzymes in some COVID-19 patients and the possible rhabdomyolysis occurring as an adverse event of statins ( Xu et al, 2020a ).…”

Antithrombotic drugs with adjuvant action against COVID-19

“…This recommendation has been recently published in a preliminary International Society on Thrombosis and Haemostasis (ISTH). 17 Furthermore, after several clinical round tables, also the use of intermediated doses of LMWH has been recently reported as safe and effective in a clinical study. 18 Of course, patients with anticoagulant contraindications should not do it.…”

Anticoagulation therapy in non-valvular atrial fibrillation in the COVID-19 era: is it time to reconsider our therapeutic strategy?

“…Cardiovascular disease and diabetes mellitus are known risk factors associated with increased mortality from COVID-19 disease. 3 In addition, AF is a common clinical manifestation in hospitalized patients with COVID‐19 and it is associated with increased mortality and/or requirement for mechanical ventilation. 4 , 5 Healthcare systems apply technologies of telemedicine and remote monitoring of patients with chronic diseases, such as AF to avoid frequent visits of patients to healthcare centres and/or hospitals.…”

“…Additionally, patients with AF are mostly elderly with multimorbidity, suffering from hypertension, and other cardiovascular comorbidities, which make them a population at high risk for severe COVID-19 course and complications. 3 Last but not the least, the well-described COVID-19 coagulopathy can also lead to abnormal coagulation parameters and alters INR levels in patients receiving long-term anticoagulation therapy with VKAs.…”

“…Although NOACs seem an attractive treatment option during the COVID-19 pandemic, we have to keep in mind the possible pharmacological interaction of NOACs with antiviral drugs and some immunomodulating agents 3 , 9 that might be used in patients hospitalized with COVID-19. In this group of patients, low molecular weight heparin (LMWH) may be preferable 9 providing not only less drug interactions but also possible antithrombotic, anti-inflammatory, and antiviral activity in COVID-19 disease.…”