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PhD defence

Antithrombotic therapy in the Netherlands- New insights from nationwide data

  • Q. Chen
Tuesday 16 April 2024
Academy Building
Rapenburg 73
2311 GJ Leiden


  • Prof.dr. S.C. Cannegieter
  • dr. N. van Rein


Antithrombotic therapy is often needed for individuals with atrial fibrillation to prevent ischemic stroke, but it meanwhile increases bleeding risk. Some coexisting conditions further complicate the optimal use of antithrombotic agents, like cancer, or by simply not adhering to the treatment. Sometimes pregnant women may also require antithrombotic therapy, but the need for taking safety of the unborn child into account makes the treatment more challenging. In the past decade, novel medications and updated clinical guidelines were introduced, but these do not necessarily lead to improvement in prognosis of individuals receiving antithrombotic therapy. Such information is very relevant to know, but usually unavailable. With the nationwide data provided by Statistics Netherlands, antithrombotic therapy in individuals with atrial fibrillation, overall or with coexisting cancer, as well as general pregnant women, were thoroughly examined. The main findings include (1) since 2013 individuals with atrial fibrillation were increasingly receiving anticoagulants driven by the direct oral anticoagulants, with decreasing risks of both ischemic stroke and major bleeding, but a substantial proportion of patients became non-persistent with the treatment which is associated with worse prognosis; (2) antiplatelet drugs were increasingly prescribed to pregnant women over years, and the risk of preeclampsia/eclampsia as well as several perinatal outcomes decreased. All the results presented in the thesis provide an overview of antithrombotic therapy in the Netherlands in recent years, providing insights for further improving this treatment and relevant patient outcomes.

PhD dissertations

Approximately one week after the defence, PhD dissertations by Leiden PhD students are available digitally through the Leiden Repository, that offers free access to these PhD dissertations. Please note that in some cases a dissertation may be under embargo temporarily and access to its full-text version will only be granted later.

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