New late-breaking science from four trials presented during ESC Congress 2021 on Aug. 29 add important contributions to the growing body of evidence surrounding the treatment and management of COVID-19 patients.

Investigators presenting on the ECLA PHRI COLCOVID trial found colchicine to be safe and associated with a non-significantly lower risk of death or need for mechanical ventilation in hospitalized patients. While results from the trial, which compared use of colchicine to placebo in 1,279 patients, require confirmation, the investigators noted their findings indicate some benefits to colchicine use in hospitalized patients.

In the MICHELLE Trial, 320 patients were randomized to either rivaroxaban (n=160) or no anticoagulation (n=160). Findings suggest that thromboprophylaxis with rivaroxaban (10 mg once-daily) for 35 days improved clinical outcomes, without increasing bleeding in patients discharged after hospitalization due to COVID-19 with increased IMPROVE scores compared with no anticoagulation post-discharge.

Results from PREPARE-IT 1 found use of icosapent ethyl (8 grams for the first three days/4 grams from day 4-60) in patients at high-risk for SARS-CoV-2 did not reduce the infection rate and there were no significant differences between icosapent ethyl and placebo in adverse events, including atrial fibrillation and bleeding. Investigators noted this is the first large, randomized, blinded trial to "demonstrate excellent safety and tolerability of an 8 gram per day loading dose of icosapent ethyl, opening up the potential for acute use in randomized trials of MI, ACS, stroke, and revascularization." The PREPARE-IT 2 trial currently underway is examining icosapent ethyl in SARS-CoV-2 positive non-hospitalized patients.

In another study, investigators provided a comprehensive analysis of the impacts of the COVID-19 pandemic on the GUIDE-HF trial, which was underway both prior to and during the pandemic. They noted significant declines in event rates in both the treatment and control groups, which ultimately had major effects on the study results. "Patients responded differently during the pandemic," the researchers said.

Clinical Topics: COVID-19 Hub, Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Pulmonary Hypertension and Venous Thromboembolism, Vascular Medicine, Hypertriglyceridemia, Acute Heart Failure

Keywords: ESC Congress, ESC21, Colchicine, COVID-19, SARS-CoV-2, Thrombosis, Venous Thromboembolism, Heart Failure, Hypertriglyceridemia, Primary Prevention

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