April 17, 2020

ACC Outlines Implications and Considerations for Thrombotic Disease Patients During COVID-19 Pandemic

April 17, 2020—The American College of Cardiology (ACC) announced the publication of a review paper delineating the implications of the COVID-19 pandemic in the prevention and management of patients with thrombotic and thromboembolic disease. The document by Behnood Bikdeli, MD, et al is available online ahead of print in Journal of the American College of Cardiology.

According to the ACC, the document summarizes the pathogenesis, epidemiology, treatment, and available outcomes data related to thrombotic disease in COVID-19 patients, as well as the management of thrombotic events in patients without COVID-19, providing clinical guidance when possible. It also outlines investigational therapies for COVID-19 and their interactions, as well as other considerations, when used in patients taking antiplatelet agents or anticoagulants.

The document’s guidance is intended to supplement, not supplant, clinical decision-making, advised the authors. Furthermore, they advise that more data are needed to understand how COVID-19 interacts with thrombotic diseases and help clinicians optimize outcomes in COVID-19 patients with pre-existing or incident thrombotic disease.

The ACC stated that the paper addresses the following:

  • Strategies to prevent venous thromboembolism (VTE) in patients with COVID-19
  • Recommendations that COVID-19 patients with respiratory failure or comorbidities, such as cancer or heart failure, should receive pharmacological prophylaxis
  • Considerations for medical and interventional therapy for VTE for patients with and without COVID-19 during the pandemic
  • Considerations for patients with COVID-19 and acute coronary syndromes treated with both antithrombotic therapy and interventional therapies

Additionally, the paper encourages awareness of important considerations for the preventive and therapeutic use of antithrombotic agents to prevent and mitigate the thrombotic and hemorrhagic events in high-risk COVID-19 patients who also have pre-existing or incident thrombotic disease.

The review, which is authored by an international collaboration of clinicians and investigators, is endorsed by the International Society on Thrombosis and Hemostasis, North American Thrombosis Forum, European Society of Vascular Medicine, and the International Union of Angiology, and is supported by the European Society of Cardiology Working Group on the Pulmonary Circulation and Right Ventricular Function, noted the ACC.


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