CCU020: Evaluation of antithrombotic use and COVID-19 outcomes

Project lead:
Alex Handy, UCL

Antithrombotics are blood thinning medications that are used to treat a range of cardiovascular diseases. Atrial fibrillation (AF) is one such disease, and is the most common disturbance of heart rhythm and a common cause of stroke. In individuals who have AF, antithrombotics are used to lower stroke risk. However, around a third of those with AF are not on the most effective type of antithrombotic or take no medication at all.

New evidence is emerging that individuals already taking antithrombotic medication (whether for AF or for another disease) may have improved outcomes if they become infected with COVID-19. However, the evidence for a protective association between antithrombotics and COVID-19 remains inconclusive.

This project will, therefore, explore three questions:

  1. How many individuals in the UK with AF are not currently on antithrombotic medication
  2. Do individuals with AF taking antithrombotic medication prior to COVID-19 infection have better outcomes (e.g. hospitalisation, mortality) than those that don’t?
  3. What factors (e.g. location, age) are associated with a lack of antithrombotic medication in individuals with AF?

In addressing these questions, this project will create the software to automatically evaluate antithrombotic use in near real-time across the whole UK population. This will provide the information to help ensure individuals with AF are given the most effective treatments and confirm whether antithrombotics offer some protection against COVID-19.


Evaluation of antithrombotic use and COVID-19 outcomes in a nationwide atrial fibrillation cohort

  • Heart publication 10/03/22 can be viewed here
  • medRxiv preprint 10/09/21 can be viewed here
  • Code and phenotypes used to produce this paper are available in GitHub here