Registry on Augmented Antithrombotic Treatment Regimens for Patients With Arterial Thrombotic APS
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 150
- 试验地点
- 3
- 主要终点
- Number of Participants with thromboembolism verified by diagnostic imaging, electrocardiogram or troponin rise
研究概览
简要总结
The goal of this registry is to gather more information on the efficacy and safety of various antithrombotic regimens. The registry collects data on patients with antiphospholipid syndrome and an arterial event within the past 12 months, on treatment with either A) a VKA with therapeutic range, INR 2.0-3.0 plus low-dose aspirin (75-100 mg daily), B) a VKA alone with therapeutic range, INR 2.0-3.0, C) a VKA with therapeutic range, INR 3.0-4.0, or D) with a dual antiplatelet regimen. The follow-up is 2 years.
详细描述
The optimal antithrombotic management of patients with antiphospholipid syndrome and arterial thrombotic events is unclear. The guidelines provide several options, mostly with vitamin K antagonist with/without an antiplatelet agent. Dual antiplatelet therapy (DAPT) was in a meta-analysis potentially effective, but included studies were few and small.
The primary aim is to compare a vitamin K antagonist (VKA), i.e. warfarin, acenocoumarol, phenprocoumon etc, with international normalized ratio 2.0-3.0 plus low-dose aspirin (75-100 mg) with DAPT - typically low-dose aspirin plus clopidogrel (75 mg daily) but other combinations will be acceptable. The registry will also include patients treated with VKA alone at standard- or high-intensity, since this is recommended and will serve as reference groups in comparison with VKA + low-dose aspirin and versus DAPT. The outcomes are (efficacy) arterial or venous thromboembolism, vascular death or (safety) major bleeding.
A secondary objective is to analyze how the cardiovascular risk factors (hypertension, hyperlipidemia, obesity, smoking, diabetes, and heart failure), venous thrombotic risk factors (previous venous thromboembolism, cancer, immobility, chronic inflammatory disease) and anti-phospholipid profile contribute to recurrent arterial thrombosis.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients of at least 18 years of age with confirmed antiphospholipid syndrome according to Sydney criteria and with first or recurrent arterial thrombotic manifestation, including those with asymptomatic brain infarcts on diagnostic imaging.
- •Treatment with either A) a vitamin K antagonist (VKA) with therapeutic range, international normalized ratio (INR) 2.0-3.0 plus low-dose aspirin (75-100 mg daily), B) a VKA alone with therapeutic range, INR 2.0-3.0 or C) VKA with therapeutic range, INR 3.0-4.0, or D) with a dual antiplatelet regimen, if considered appropriate by the treating physician.
- •Signed informed consent obtained (in jurisdictions where required).
排除标准
- •Inability to follow the patient due to geographical or other reasons.
- •Patients with documented poor compliance.
- •Bleeding risk that in the opinion of the treating physician makes combination antithrombotic therapy unsafe.
- •Pregnancy or planned pregnancy.
- •Venous thrombotic event diagnosed after the last arterial event.
结局指标
主要结局
Number of Participants with thromboembolism verified by diagnostic imaging, electrocardiogram or troponin rise
时间窗: 2 years
Composite of arterial thrombosis (stroke, myocardial infarction, peripheral arterial thrombosis or embolism), venous thromboembolism (thrombosis in any deep vein or pulmonary embolism), and vascular death.
Number of Participants with major hemorrhage fulfilling at least one of the International Society on Thrombosis and Haemostasis criteria
时间窗: 2 years
Major hemorrhage according to the International Society on Thrombosis and Haemostasis
次要结局
- Number of Participants with vascular death verified by diagnostic imaging, electrocardiogram or troponin rise(2 years)
- Number of Participants with venous thromboembolism verified by diagnostic imaging(2 years)
- Number of Participants with arterial thrombosis verified by diagnostic imaging(2 years)