Imperial College London
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Professor Anthony Gordon

Faculty of Medicine, Department of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
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Contact

 

anthony.gordon

 
 
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Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{REMAP-CAP:2022:10.1001/jama.2022.2910,
author = {REMAP-CAP, Writing Committee for the REMAP-CAP Investigators and Bradbury, CA and Lawler, PR and Stanworth, SJ and McVerry, BJ and McQuilten, Z and Higgins, AM and Mouncey, PR and Al-Beidh, F and Rowan, KM and Berry, LR and Lorenzi, E and Zarychanski, R and Arabi, YM and Annane, D and Beane, A and van, Bentum-Puijk W and Bhimani, Z and Bihari, S and Bonten, MJM and Brunkhorst, FM and Buzgau, A and Buxton, M and Carrier, M and Cheng, AC and Cove, M and Detry, MA and Estcourt, LJ and Fitzgerald, M and Girard, TD and Goligher, EC and Goossens, H and Haniffa, R and Hills, T and Huang, DT and Horvat, CM and Hunt, BJ and Ichihara, N and Lamontagne, F and Leavis, HL and Linstrum, KM and Litton, E and Marshall, JC and McAuley, DF and McGlothlin, A and McGuinness, SP and Middeldorp, S and Montgomery, SK and Morpeth, SC and Murthy, S and Neal, MD and Nichol, AD and Parke, RL and Parker, JC and Reyes, L and Saito, H and Santos, MS and Saunders, CT and Serpa-Neto, A and Seymour, CW and Shankar-Har},
doi = {10.1001/jama.2022.2910},
journal = {JAMA: Journal of the American Medical Association},
pages = {1247--1259},
title = {Effect of antiplatelet therapy on survival and organ support-free days in critically ill patients with COVID-19: a randomized clinical trial},
url = {http://dx.doi.org/10.1001/jama.2022.2910},
volume = {327},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Importance: The efficacy of antiplatelet therapy in critically ill patients with COVID-19 is uncertain. Objective: To determine whether antiplatelet therapy improves outcomes for critically ill adults with COVID-19. Design, Setting, and Participants: In an ongoing adaptive platform trial (REMAP-CAP) testing multiple interventions within multiple therapeutic domains, 1557 critically ill adult patients with COVID-19 were enrolled between October 30, 2020, and June 23, 2021, from 105 sites in 8 countries and followed up for 90 days (final follow-up date: July 26, 2021). Interventions: Patients were randomized to receive either open-label aspirin (n = 565), a P2Y12 inhibitor (n = 455), or no antiplatelet therapy (control; n = 529). Interventions were continued in the hospital for a maximum of 14 days and were in addition to anticoagulation thromboprophylaxis. Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of intensive care unit-based respiratory or cardiovascular organ support) within 21 days, ranging from -1 for any death in hospital (censored at 90 days) to 22 for survivors with no organ support. There were 13 secondary outcomes, including survival to discharge and major bleeding to 14 days. The primary analysis was a bayesian cumulative logistic model. An odds ratio (OR) greater than 1 represented improved survival, more organ support-free days, or both. Efficacy was defined as greater than 99% posterior probability of an OR greater than 1. Futility was defined as greater than 95% posterior probability of an OR less than 1.2 vs control. Intervention equivalence was defined as greater than 90% probability that the OR (compared with each other) was between 1/1.2 and 1.2 for 2 noncontrol interventions. Results: The aspirin and P2Y12 inhibitor groups met the predefined criteria for equivalence at an adaptive analysis and were statistically pooled for further analysis. Enrollment
AU  - REMAP-CAP,Writing Committee for the REMAP-CAP Investigators
AU  - Bradbury,CA
AU  - Lawler,PR
AU  - Stanworth,SJ
AU  - McVerry,BJ
AU  - McQuilten,Z
AU  - Higgins,AM
AU  - Mouncey,PR
AU  - Al-Beidh,F
AU  - Rowan,KM
AU  - Berry,LR
AU  - Lorenzi,E
AU  - Zarychanski,R
AU  - Arabi,YM
AU  - Annane,D
AU  - Beane,A
AU  - van,Bentum-Puijk W
AU  - Bhimani,Z
AU  - Bihari,S
AU  - Bonten,MJM
AU  - Brunkhorst,FM
AU  - Buzgau,A
AU  - Buxton,M
AU  - Carrier,M
AU  - Cheng,AC
AU  - Cove,M
AU  - Detry,MA
AU  - Estcourt,LJ
AU  - Fitzgerald,M
AU  - Girard,TD
AU  - Goligher,EC
AU  - Goossens,H
AU  - Haniffa,R
AU  - Hills,T
AU  - Huang,DT
AU  - Horvat,CM
AU  - Hunt,BJ
AU  - Ichihara,N
AU  - Lamontagne,F
AU  - Leavis,HL
AU  - Linstrum,KM
AU  - Litton,E
AU  - Marshall,JC
AU  - McAuley,DF
AU  - McGlothlin,A
AU  - McGuinness,SP
AU  - Middeldorp,S
AU  - Montgomery,SK
AU  - Morpeth,SC
AU  - Murthy,S
AU  - Neal,MD
AU  - Nichol,AD
AU  - Parke,RL
AU  - Parker,JC
AU  - Reyes,L
AU  - Saito,H
AU  - Santos,MS
AU  - Saunders,CT
AU  - Serpa-Neto,A
AU  - Seymour,CW
AU  - Shankar-Hari,M
AU  - Singh,V
AU  - Tolppa,T
AU  - Turgeon,AF
AU  - Turner,AM
AU  - van,de Veerdonk FL
AU  - Green,C
AU  - Lewis,RJ
AU  - Angus,DC
AU  - McArthur,CJ
AU  - Berry,S
AU  - Derde,LPG
AU  - Webb,SA
AU  - Gordon,AC
DO  - 10.1001/jama.2022.2910
EP  - 1259
PY  - 2022///
SN  - 0098-7484
SP  - 1247
TI  - Effect of antiplatelet therapy on survival and organ support-free days in critically ill patients with COVID-19: a randomized clinical trial
T2  - JAMA: Journal of the American Medical Association
UR  - http://dx.doi.org/10.1001/jama.2022.2910
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35315874
UR  - https://jamanetwork.com/journals/jama/fullarticle/2790488
UR  - http://hdl.handle.net/10044/1/101350
VL  - 327
ER  -
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