A5049795850- Atrial Fibrillation Management and Outcomes
- Venous Thromboembolism Diagnosis and Management
- Blood Coagulation and Thrombosis Mechanisms
- Hemophilia Treatment and Research
- Blood Pressure and Hypertension Studies
- Cardiac Arrhythmias and Treatments
- Vitamin K Research Studies
- Antiplatelet Therapy and Cardiovascular Diseases
- Coagulation, Bradykinin, Polyphosphates, and Angioedema
- Pharmacogenetics and Drug Metabolism
- Platelet Disorders and Treatments
- Heparin-Induced Thrombocytopenia and Thrombosis
- Cardiac electrophysiology and arrhythmias
- Central Venous Catheters and Hemodialysis
- Health Systems, Economic Evaluations, Quality of Life
- Cardiovascular Issues in Pregnancy
- Clinical Laboratory Practices and Quality Control
- COVID-19 Clinical Research Studies
- Eicosanoids and Hypertension Pharmacology
- Medication Adherence and Compliance
- Pharmaceutical studies and practices
- Acute Myocardial Infarction Research
- Cancer Treatment and Pharmacology
- Long-Term Effects of COVID-19
- Blood properties and coagulation
Leiden University Medical Center
2015-2024
Hersenstichting
2023
Leiden University
1991-2022
DDL Diagnostic Laboratory
2012
Thrombosis Research Institute
1995-2012
Loyola University Medical Center
2011
University Hospital Frankfurt
2005
Goethe University Frankfurt
1997-2005
Hospital de Sant Pau
1997-2005
Policlinico S.Orsola-Malpighi
1997-2005
Oral anticoagulant therapy has been shown to be effective for several indications. The optimal intensity of anticoagulation each indication, however, is largely unknown. To determine this intensity, randomised clinical trials are conducted in which two target levels compared. This approach inefficient, since the choice will arbitrary. Moreover, achieved not taken into account. We propose a method anticoagulation. can applied within trial as an "efficacy-analysis", but also on data gathered...
The optimal intensity of oral anticoagulant therapy for patients with mechanical heart valves (i.e., the level at which thromboembolic complications are effectively prevented without excessive bleeding) is not known. We attempted to determine by calculating incidence both different levels anticoagulation.
<h3>Background:</h3> Insufficient data are available about the safety of oral anticoagulant therapy. The specialized organization thrombosis services in Netherlands can provide important information on bleeding risk and various factors for patients receiving <h3>Methods:</h3> In a follow-up study over 12-month period beginning January 1988 all treated by Leiden Thrombosis Service, frequency complications was assessed. A Poisson regression model used to assess relative contribution age, sex,...
Background: A positive family history of venous thrombosis may reflect the presence genetic risk factors.Once a factor has been identified, it is not known whether additional value in predicting an individual's risk.We studied contribution to relation factors.Methods: In Multiple Environmental and Genetic Assessment factors for thrombosis, population-based case-control study, we collected blood samples information about environmental triggers from 1605 patients with first 2159 control...
Observational evidence suggests that the use of a genotype-guided dosing algorithm may increase effectiveness and safety acenocoumarol phenprocoumon therapy.We conducted two single-blind, randomized trials comparing included clinical variables genotyping for CYP2C9 VKORC1 with only variables, initiation or treatment in patients atrial fibrillation venous thromboembolism. The primary outcome was percentage time target range international normalized ratio (INR; range, 2.0 to 3.0) 12-week...
Study Design (5) LETS was designed to assess the importance at population level of various risk factors for thrombosis, many which had been identified by family studies. Generally, two approaches are possible: cohort studies and case-control In former, patients with without a factor followed over time, absolute risks (probability disease, incidence) relative (incidence rate ratio) can be calculated. study, thrombosis healthy controls included, (odds ratios) Due rarity genetic follow-up study...
<h3>Background</h3> Oral anticoagulation in the elderly is a dilemma. Although many patients have strict indications for treatment with coumarin derivatives, tendency toward an increased bleeding risk age matter of concern. We investigated hemorrhage and thromboembolism according to who were treated oral anticoagulants routine setting clinic. <h3>Methods</h3> All Leiden Anticoagulation Clinic (Leiden, Netherlands) because mechanical heart valve prostheses (target, international normalized...
Purpose We studied whether the risk of central venous catheter (CVC) -related thrombosis increased after an episode CVC-related infection in patients undergoing intensive chemotherapy. Secondly, we determined can be predicted or excluded by CVC lock fluid surveillance cultures. Patients and Methods In a prospective setting, 105 consecutive were carefully examined for thrombosis. all patients, microbial cultures taken every other day. All with clinical suspicion underwent Doppler ultrasound...
Summary In two cohorts of patients on oral anticoagulant therapy, routinely treated by the Leiden Thrombosis Service, frequency major bleeding complications was assessed during years (1988 and 1991). With Poisson regression analysis influence risk factors age, sex, target zone, achieved INR type coumarin derivative used were determined. Subsequently, a index calculated, combining results cohorts. For various types relative assessed. Age most important consistent factors: rate ratio (RR) for...
AimsPolymorphisms in CYP2C9 and VKORC1 influence patients' phenprocoumon (PHE) acenocoumarol (ACE) dose requirements. To provide physicians with tools to estimate the patient's individual dose, we aimed develop algorithms for PHE ACE.
Objective The HAS-BLED score enables a risk estimate of major bleeds in patients with atrial fibrillation on vitamin K-antagonists (VKA) treatment, but has not been validated for venous thromboembolism (VTE). We analyzed whether the accurately identifies at high during VKA treatment acute VTE. Methods Medical records 537 VTE (primary diagnosis pulmonary embolism 223, deep vein thrombosis 314) starting between 2006-2007 were searched items and occurrence first 180 days follow-up. hazard ratio...
BackgroundIn recent years, more awareness is raised about sex-specific dilemmas in inherited bleeding disorders. However, no large studies have been performed to assess differences diagnosis, phenotype and management of men women with Therefore, we investigated sex a cohort well-defined patients autosomal disorders (von Willebrand disease (VWD), rare (RBDs) congenital platelet defects (CPDs)).MethodsWe included from three nationwide cross-sectional on VWD, RBDs CPDs the Netherlands,...
Background: Several studies have demonstrated that patient self-management of oral anticoagulant therapy (OAT) can improve treatment quality.However, most these were not conducted within a specialized anticoagulation care system.The objective the present study was to determine whether OAT improves quality delivered by clinics.Methods: In this randomized 2 Dutch clinics 341 patients aged between 18 and 75 years receiving long-term divided into 4 groups: an existing routine group untrained in...
In a prospective follow-up study of the effects VKORC1 and CYP2C9 genotypes on anticoagulation status patients, we assessed C1173T patients during initial 6 months phenprocoumon treatment. We used linear regression models Cox proportional hazard to determine dose requirements, overanticoagulation, time achieve stability. Allele frequencies interest within cohort (N=281) were 40.8% T-1173, 12.8% CYP2C9*2, 6.9% CYP2C9*3. with CC genotype, carriers polymorphism needed dosages that nearly 30%...
Objective— Few comprehensive data are available on the recurrence rate of venous thrombosis in carriers thrombophilic defects from families. We prospectively determined after a first thrombotic event patients with familial thrombophilia attributable to factor V Leiden or deficiencies protein C, S, antithrombin. Methods and Results— Data were gathered during follow-up occurrence risk situations, anticoagulation treatment, events (eg, thrombosis, hemorrhage). Over mean period 5.6 years, 44 180...