Antithrombotic therapy in the Netherlands: new insights from nationwide data

Chen, Q. (2024)

Doctoral Thesis

Thromboembolic complications remain a major public health burden, making antithrombotic agents one of the most widely prescribed groups of medication, but the treatment is often challenging as it at the same time increases risk of bleeding. With nationwide data from Statistics Netherlands, antithrombotic therapy and relevant clinical outcomes were comprehensively examined in the patient population of atrial fibrillation, overall or among those with comorbid cancer. The results suggest the patient population was increasingly receiving anticoagulants, driven by the newly introduced medication- direct oral anticoagulant and guided by the CHA2DS2-VASc score, and meanwhile the patient population experienced fewer ischemic stroke and major bleeding. In spite of these promising changes, suboptimal medication adherence and potential underuse of anticoagulants remain directions for further improvement. Antithrombotic agent use during pregnancy was also examined in the general Dutch pregnant population, which featured a surge in antiplatelet prescriptions, and risk of preeclampsia/eclampsia decreased and several newborn outcomes improved simultaneously. Together, the studies presented in this thesis provide an overview of antithrombotic therapy in the Netherlands in recent years, providing insights for further improving this treatment and relevant patient outcomes.

• Anticoagulants
• Platelet Aggregation Inhibitors
• Atrial Fibrillation
• Cardio-Oncology
• Pregnancy
• COVID-19
• Epidemiology
• Netherlands

• All authors: Chen, Q.
• Supervisor: Cannegieter, S.C.
• Co-supervisor: Rein, N. van
• Committee: Kruip, M.J.H.A.; Trines, S.A.I.P.; Groenwold, R.H.H.; Bemt, P.M.L.A. van den
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2024-04-16
• ISBN (print): 9789090383026