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Anticoagulation in COVID-19 Trial Results

Wednesday, August 4th

The ACTIV4-a, ATTACC, & REMAP-CAP investigators presented the results of this multi-platform trial, in which critically ill and non-critically ill adults were randomized to receive therapeutic anticoagulation with heparin or pharmacological thromboprophylaxis as per local usual care. The preprint of the main paper was published on March 12th in MedRxiv.

COVID-19 Anticoagulation Trial Results Presentation

Drs Patrick Lawler (Toronto), Lindsay Berry (Austin) & Ewan Goligher (Toronto) present the results of the multiplatform COVID-19 Anticoagulation Trial Results at a livestreamed Critical Care Reviews Trials Results Meeting, on August 4th, 2021. The results presentation was synchronised with the publication of the two results papers in the New England Journal of Medicine

Editorial

Charlotte Summers (Cambridge)

Viewer's Questions

Viewer's questions posed by Dr Peter McGuigan (Belfast)

Panel Discussion

An international panel of experts discuss the robustness and implications of the COVID-19 Anticoagulation Trial at a livestreamed Critical Care Reviews Trial Results Meeting, on August 4th, 2021.The panel include Profs Judith Hochman (New York), Saskia Middledorp (Nijmegen) and James Douketis (Hamilton).

Selected Global Timings

Toronto

16:30 to 18:00

Winnipeg

15:30 to 17:00

San Francisco

13:30 to 15:00

Sydney (5th)

06:30 to 08:00

Beijing (5th)

04:30 to 06:00

Mumbai (5th)

02:00 to 03:30

Nairobi

23:30 to 01:00

Rome

22:30 to 00:00

Dublin

21:30 to 23:00

Schedule

00:00
Introduction

Ewan Goligher

00:10
Statistical Plan

Lindsay Berry

00:20
Results

Patrick Lawler

00:30
Editorial

Charlotte Summers

00:40
Reply to the Editorial

Ryan Zarychanski

00:45
Questions

Open to Viewers

00:55
Panel Discussion

Ryan Zarychanski

Lindsay Berry

Charlotte Summers

Judith Hochman

Saskia Middledorp

Jim Douketis

01:30
End

Speakers

Ewan Goligher

Assistant Professor of Medicine, University of Toronto, Canada

Dr. Goligher trained in Internal Medicine and Critical Care Medicine at the University of Toronto and subsequently earned a doctoral degree in physiology from the University of Toronto, focusing on diaphragmatic dysfunction during mechanical ventilation. His research program focuses on characterizing the mechanisms and impact of injury to the lung and diaphragm during mechanical ventilation and on the use of innovative clinical trial designs to test lung and diaphragm-protective ventilation strategies.

Twitter:  @ecgoligher

Lindsay Berry

Statistical Scientist, Berry Consultants, Austin, USA

Lindsay Berry is a Statistical Scientist at Berry Consultants. She earned her Ph.D. in Statistical Science from Duke University in 2019. Her research interests include forecasting and time series analysis, Bayesian dynamic models, hierarchical models, high-dimensional computation, decision analysis, and statistical computing. Prior to graduate school, Lindsay received her B.S. in Mathematics from the University of Texas at Austin and completed a thesis on simulation control of seamless phase II/III clinical trials.

Twitter:  @lindsrberry

Patrick Lawler

Assistant Professor of Medicine, University of Toronto, Canada

Patrick Lawler is a clinician-scientist at the Peter Munk Cardiac Centre at University Health Network, where he attends in the cardiac intensive care unit, and an Assistant Professor of Medicine at the University of Toronto. His current research represents a diverse but interconnected program of science aimed at developing precision-medicine approaches for the prevention and treatment of critical illness. Much of this work has a strong scientific focus on inflammation and metabolism, at the mechanistic intersection between cardiogenic shock and sepsis. Many of these studies are built on molecular epidemiology / systems biology approaches, and leverage advances in high-dimensional molecular data acquisition and analysis in patient cohorts. He also has an interest in post-sepsis cardiovascular disease complications.

Twitter:  @PatrickLawlerMD

Charlotte Summers

Reader in Intensive Care Medicine, University of Cambridge, England

Charlotte Summers is an academic critical care physician with a passion for translating basic science into therapies for critically ill patients. She graduated in Biomedical Sciences and Medicine from the University of Southampton, and later undertook a PhD at the University of Cambridge alongside specialist clinical training in Respiratory and Intensive Care Medicine. Charlotte was later appointed as the UK’s first NIHR Clinical Lecturer in Intensive Care Medicine, and went on to earn a Fulbright All-disciplines Scholar Award and a Wellcome Trust Postdoctoral Fellowship for Clinician Scientists. In 2015, Charlotte returned to Cambridge from the University of California San Francisco. Her current roles include: University Lecturer in Intensive Care Medicine; Honorary Consultant in Intensive Care Medicine, Cambridge University Hospitals NHS Foundation Trust; Deputy Director of Clinical Academic Training, University of Cambridge School of Clinical Medicine; Dean, Fellow, and Director of Studies in Clinical Medicine, Selwyn College, Cambridge.

Twitter:  @charlot_summers

Ryan Zarychanski

Associate Professor of Medicine, University of Manitoba, Canada

Dr. Zarychanski, is an Associate Professor, Critical Care physician, Hematologist, and Clinician-Scientist at the University of Manitoba and CancerCare Manitoba. He’s a senior scientist at the Research Institute of Oncology and Hematology and an affiliate member of the George and Fay Yee Centre for Healthcare Innovation. His research focuses on the hematologic aspects of critical illness where he leads national and international randomized trials in the fields of sepsis and transfusion medicine.

Twitter:  @RZarychanski

Judith Hochman

Professor of Cardiology, NYU Grossman School of Medicine, USA

Dr. Hochman is Senior Associate Dean for Clinical Sciences, Co-Director of the NYU-HHC Clinical and Translational Science Institute, Harold Snyder Family Professor and Associate Director of the Leon Charney Division of Cardiology, and Director of the Cardiovascular Clinical Research Center at the New York University School of Medicine. Her particular areas of interest include the management of ischemic heart disease, both acute and chronic, with a special interest in the role of revascularization with either PCI or CABG, the pathophysiology and management of cardiogenic shock, and optimized management based on sex differences. She is currently the Study Chair of the ISCHEMIA Trial, comparing two strategies for the management of patients with stable coronary artery disease.

Dr. Hochman has served on numerous steering and executive committees for multi-center ischemic heart disease clinical trials including MAGIC, APEX-AMI, SOLID-TIMI 52, STABILITY, TRILOGY, and EARLY ACS. She has served as a member and chair of numerous Data and Safety Monitoring Boards (DSMBs) on trials sponsored by NIH and industry. In recognition of her scientific contributions she was awarded the 2014 AHA Clinical Research Prize and the 2016 ACC Distinguished Scientist Award (Clinical Domain).

Jim Douketis

Professor of Medicine, McMaster University, Canada

Dr. James Douketis is the Director of the Vascular Medicine Program and Staff Physician in Vascular Medicine and General Internal Medicine at St. Joseph’s Healthcare Hamilton. He is a Professor in the Department of Medicine at McMaster University and the Associate Director of the Clinical Teaching Unit at St. Joseph’s Healthcare. He received his Doctor of Medicine degree and completed his residency in Internal Medicine at the University of Toronto. He then completed a fellowship in thromboembolic disease at McMaster University.  Dr. Douketis’ research interests include perioperative antithrombotic therapy, prognosis of patients with venous thromboembolism, bleeding risks during antithrombotic therapy, hormonal therapy and thrombosis, prevention of venous thromboembolism in medical patients, and clinical practice guideline development for the prevention and treatment of obesity.

Saskia Middledorp

Professor of Internal Medicine, Radboud University, The Netherlands

Saskia Middeldorp was trained as a physician and internist in Amsterdam, where she also received her PhD in thrombosis and thrombophilia. After her training as an internist, she continued her career as a staff member at the AMC. From 2006 to July 2010, she worked at Leiden University Medical Center. In 2010 Saskia Middeldorp returned to Amsterdam and was appointed Professor of Internal Medicine at the AMC. She became co-head of the Department of Vascular Medicine, chaired the residency program in Vascular Medicine, and led the research lines in the field of Thrombosis and Hemostasis.

Twitter: @MiddeldorpS

Multiplatform Trials

Preprints

The ATTACC, ACTIV-4a, and REMAP-CAP Investigators. Therapeutic Anticoagulation in Critically Ill Patients with Covid-19. MedRxiv 2021;epublished March 12th

The ATTACC, ACTIV-4a, and REMAP-CAP Investigators. Therapeutic Anticoagulation in Non-Critically Ill Patients with Covid-19. MedRxiv 2021;epublished May 17th