{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T01:00:49Z","timestamp":1769907649767,"version":"3.49.0"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Thrombotic complications are considered among the main extrapulmonary manifestations of coronavirus disease 2019 (COVID-19). The optimal type and duration of prophylactic antithrombotic therapy in these patients remain unknown.<\/jats:p><jats:p>\n          Methods\u2003This article reports the final (90-day) results of the Intermediate versus Standard-dose Prophylactic anticoagulation In cRitically-ill pATIents with COVID-19: An opeN label randomized controlled trial (INSPIRATION) study. Patients with COVID-19 admitted to intensive care were randomized to intermediate-dose versus standard-dose prophylactic anticoagulation for 30 days, irrespective of hospital discharge status. The primary efficacy outcome was a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation (ECMO), or all-cause death. The main safety outcome was major bleeding.<\/jats:p><jats:p>\n          Results\u2003Of 600 randomized patients, 562 entered the modified intention-to-treat analysis (median age [Q1, Q3]: 62 [50, 71] years; 237 [42.2%] women), of whom 336 (59.8%) survived to hospital discharge. The primary outcome occurred in 132 (47.8%) of patients assigned to intermediate dose and 130 (45.4%) patients assigned to standard-dose prophylactic anticoagulation (hazard ratio [HR]: 1.21, 95% confidence interval [CI]: 0.95\u20131.55, p\u2009=\u20090.11). Findings were similar for other efficacy outcomes, and in the landmark analysis from days 31 to 90 (HR: 1.59, 95% CI: 0.45\u20135.06). There were 7 (2.5%) major bleeding events in the intermediate-dose group (including 3 fatal events) and 4 (1.4%) major bleeding events in the standard-dose group (none fatal) (HR: 1.82, 95% CI: 0.53\u20136.24).<\/jats:p><jats:p>\n          Conclusion\u2003Intermediate-dose compared with standard-dose prophylactic anticoagulation did not reduce a composite of death, treatment with ECMO, or venous or arterial thrombosis at 90-day follow-up.<\/jats:p>","DOI":"10.1055\/a-1485-2372","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T22:47:25Z","timestamp":1618699645000},"page":"131-141","source":"Crossref","is-referenced-by-count":51,"title":["Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial"],"prefix":"10.1055","volume":"122","clinical-trial-number":[{"clinical-trial-number":"nct04486508","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Behnood","family":"Bikdeli","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Yale\/YNHH Center for Outcomes Research and Evaluation, New Haven, Connecticut, United States"},{"name":"Cardiovascular Research Foundation, New York, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azita H.","family":"Talasaz","sequence":"first","affiliation":[{"name":"Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farid","family":"Rashidi","sequence":"additional","affiliation":[{"name":"Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hooman","family":"Bakhshandeh","sequence":"additional","affiliation":[{"name":"Clinical Trial Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran"},{"name":"Rajaie Cardiovascular Medical and Research Center, Iran university of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farnaz","family":"Rafiee","sequence":"additional","affiliation":[{"name":"Rajaie Cardiovascular Medical and Research Center, Iran university of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parisa","family":"Rezaeifar","sequence":"additional","affiliation":[{"name":"Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elahe","family":"Baghizadeh","sequence":"additional","affiliation":[{"name":"Rajaie Cardiovascular Medical and Research Center, Iran university of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samira","family":"Matin","sequence":"additional","affiliation":[{"name":"Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sepehr","family":"Jamalkhani","sequence":"additional","affiliation":[{"name":"Student Research Committee, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ouria","family":"Tahamtan","sequence":"additional","affiliation":[{"name":"Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Babak","family":"Sharif-Kashani","sequence":"additional","affiliation":[{"name":"Tobacoo Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran"},{"name":"Department of Cardiology, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Taghi","family":"Beigmohammadi","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohsen","family":"Farrokhpour","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Firouzgar Hospital, Iran 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Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keivan Gohari","family":"Moghadam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Shariati Hospital, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossein","family":"Khalili","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahdi","family":"Yadollahzadeh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taghi","family":"Riahi","sequence":"additional","affiliation":[{"name":"Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, 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