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Master Thesis

Quand associer anticoagulants oraux et antiagrégants plaquettaires dans la pratique de la médecine générale‎ : une revue de la littérature

Abstract : Combinations of antiplatelet and anticoagulant drugs are commonly used in general practice across all kind of population, even at risk. Strategies to improve the effectiveness of these therapies include selecting the optimal antithrombotic therapy, in association or not. The goal was to create a review of all available, methodologically sound data to assess the safety and efficacy of combined oral anticoagulant and antiplatelet therapy versus antithrombotic monotherapy in patients with an indication of such treatments. We have done a combined search, from 01 January 1980 to 04 May 2014, on The Cochrane Library, and MEDLINE to include randomized controlled trials, meta-analyses and systematics reviews. We have also manually looked at each reference lists of individual included studies. We included reports published in French or English language. Two review authors independently performed the search strategy, assessed trials for inclusion and study quality, and extracted data. Forty six studies have been included in this research. We identified three situations where the association of oral anticoagulant and antiplatelet therapy has proven its validity: They were for patient: - With a prosthetic heart valve. - With stented coronary syndrome in the year of a myocardial infarction and a formal indication of oral anticoagulation by VKA. - With peripheral arterial disease with a formal indication of oral anticoagulation by VKA. These strategies have to be adapted to the thromboembolic and hemorrhagic risk of each patient. This search tried to propose a prescription tool for antithrombotic treatment. Combined with scales like HAS-BLED and CHADS-VASC, it could help the general practitioner to prescribe accurate and safe antithrombotic therapy for his patient.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01069079
Contributor : Jean-Hugues Morneau <>
Submitted on : Friday, September 26, 2014 - 6:39:31 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Friday, April 14, 2017 - 12:55:28 PM

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  • HAL Id : dumas-01069079, version 1

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Gabriel O'Connell, Yann Peltier. Quand associer anticoagulants oraux et antiagrégants plaquettaires dans la pratique de la médecine générale‎ : une revue de la littérature. Médecine humaine et pathologie. 2014. ⟨dumas-01069079⟩

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