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4. Safety and efficacy of new oral anticoagulants and low-molecular-weight heparins compared with aspirin in patients undergoing total knee and hip replacements

Author

Nielen, Johannes T H, Dagnelie, Pieter C, Emans, Pieter J, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, Boonen, Annelies E R C H, van den Bemt, Bart J F, de Vries, Frank, Sub Pharmacotherapy, Theoretical, Sub Pharmacoepidemiology, Sub Gen. Pharmacoepi and Clinical Pharm, Pharmacoepidemiology and Clinical Pharmacology, RS: CAPHRI - R5 - Optimising Patient Care, Epidemiologie, Farmacologie en Toxicologie, MUMC+: DA KFT Medische Staf (9), RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, MUMC+: MA Orthopedie (9), Orthopedie, MUMC+: MA Reumatologie (9), Interne Geneeskunde, Sub Pharmacotherapy, Theoretical, Sub Pharmacoepidemiology, Sub Gen. Pharmacoepi and Clinical Pharm, and Pharmacoepidemiology and Clinical Pharmacology

Subjects
Male, pharmacoepidemiology, Arthroplasty, Replacement, Hip, new oral anticoagulants, Administration, Oral, Cohort Studies, 0302 clinical medicine, low-molecular-weight heparins, Hip replacement, Epidemiology, Taverne, Pharmacology (medical), 030212 general & internal medicine, Arthroplasty, Replacement, Knee, Aged, 80 and over, 030222 orthopedics, Aspirin, education.field_of_study, Middle Aged, Pharmacoepidemiology, Female, epidemiology, Gastrointestinal Hemorrhage, medicine.drug, Risk, medicine.medical_specialty, aspirin, Population, venous thromboembolism, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, medicine, Journal Article, Humans, Comparative Study, Medical prescription, education, Aged, Proportional Hazards Models, Retrospective Studies, business.industry, Anticoagulants, Retrospective cohort study, Heparin, Low-Molecular-Weight, Concomitant drug, mortality, Surgery, GI bleeding, business, Platelet Aggregation Inhibitors, Follow-Up Studies
Abstract

BACKGROUND: There has been much debate recently on the best type of thromboprophylaxis following elective total joint replacement surgery.OBJECTIVE: This study aims to compare rates of venous thromboembolism (VTE), gastro-intestinal (GI) bleeding and mortality events, with use of new oral anticoagulants (NOAC) or low-molecular-weight heparins (LMWHs) compared with aspirin in patients undergoing total joint replacement.METHODS: A population-based retrospective cohort study was performed using the Clinical Practice Research Datalink. Patients ≥18 years of age who had undergone total knee (n = 3261) or hip replacement (THR (n = 4016)) between 2008 and 2012 were included. Within this population, three cohorts were selected, based on their first prescription within the 35-day period after surgery: use of NOACs only, LMWHs only and aspirin only. Incidence rates were calculated, and Cox proportional hazard models were fitted to estimate the risk of VTE, GI bleeding and all-cause mortality with the use of NOACs and LMWHs compared with aspirin use after total knee replacement and THR. We statistically adjusted our analyses for lifestyle factors, comorbidities and concomitant drug use.RESULTS: Total knee replacement and THR patients currently on LMWHs had higher risk of VTE (HR = 17.2 (6.9-43.0) and HR = 39.5 (18.0-87.0), respectively), GI bleeding (HR = 20.9 (1.9-232.3) and HR = 2.0 (0.2-17.2), respectively) and all-cause mortality (HR = 4.3 (1.7-12.4) and HR = 4.0 (2.4-6.7), respectively). NOAC use was associated with an increased risk of GI bleeding in patients undergoing THR surgery.CONCLUSIONS: In contrast to previous studies, we found an increased risk of VTE, GI bleeding and all-cause mortality with the use of LMWHs compared with aspirin. Risk of GI bleeding was increased with the use of NOACs compared with aspirin use after THR surgery. Copyright © 2016 John Wiley & Sons, Ltd.

Published
2016
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5. Long-term exposure to particulate matter, NO2 and the oxidative potential of particulates and diabetes prevalence in a large national health survey

Author

Strak, Maciej, Veldhorst-Janssen, Nicole, Beelen, Rob, Schmitz, Oliver, Vaartjes, Ilonca, Karssenberg, Derek, van den Brink, Carolien, Bots, Michiel L., Dijst, Martin, Brunekreef, Bert, Hoek, Gerard, Strak, Maciej, Veldhorst-Janssen, Nicole, Beelen, Rob, Schmitz, Oliver, Vaartjes, Ilonca, Karssenberg, Derek, van den Brink, Carolien, Bots, Michiel L., Dijst, Martin, Brunekreef, Bert, and Hoek, Gerard

Published
2017

6. Long-term exposure to particulate matter, NO2 and the oxidative potential of particulates and diabetes prevalence in a large national health survey

Author

UMC Utrecht, Cardiovasculaire Epi Team 5, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Epi Infectieziekten Team 3, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Strak, Maciej, Veldhorst-Janssen, Nicole, Beelen, Rob, Schmitz, Oliver, Vaartjes, Ilonca, Karssenberg, Derek, van den Brink, Carolien, Bots, Michiel L., Dijst, Martin, Brunekreef, Bert, Hoek, Gerard, UMC Utrecht, Cardiovasculaire Epi Team 5, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Epi Infectieziekten Team 3, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Strak, Maciej, Veldhorst-Janssen, Nicole, Beelen, Rob, Schmitz, Oliver, Vaartjes, Ilonca, Karssenberg, Derek, van den Brink, Carolien, Bots, Michiel L., Dijst, Martin, Brunekreef, Bert, and Hoek, Gerard

Published
2017

7. Safety And Efficacy Of New Oral Anticoagulants, And Low Molecular Weight Heparins Compared To Aspirin Associated With Total Knee And Hip Replacement

Author

Nielen, Johannes T. H., Dagnelie, Pieter C., de Vries, Frank, Emans, Pieter, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, van den Bemt, Bart, Boonen, Annelies, Nielen, Johannes T. H., Dagnelie, Pieter C., de Vries, Frank, Emans, Pieter, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, van den Bemt, Bart, and Boonen, Annelies

Published
2016

8. Safety And Efficacy Of New Oral Anticoagulants, And Low Molecular Weight Heparins Compared To Aspirin Associated With Total Knee And Hip Replacement

Author

Sub Gen. Pharmacoepi and Clinical Pharm, Sub Pharmacotherapy, Theoretical, Sub Pharmacoepidemiology, Pharmacoepidemiology and Clinical Pharmacology, Nielen, Johannes T. H., Dagnelie, Pieter C., de Vries, Frank, Emans, Pieter, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, van den Bemt, Bart, Boonen, Annelies, Sub Gen. Pharmacoepi and Clinical Pharm, Sub Pharmacotherapy, Theoretical, Sub Pharmacoepidemiology, Pharmacoepidemiology and Clinical Pharmacology, Nielen, Johannes T. H., Dagnelie, Pieter C., de Vries, Frank, Emans, Pieter, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, van den Bemt, Bart, and Boonen, Annelies

Published
2016

9. Safety and efficacy of new oral anticoagulants and low-molecular-weight heparins compared with aspirin in patients undergoing total knee and hip replacements

Author

Sub Pharmacotherapy, Theoretical, Sub Pharmacoepidemiology, Sub Gen. Pharmacoepi and Clinical Pharm, Pharmacoepidemiology and Clinical Pharmacology, Nielen, Johannes T H, Dagnelie, Pieter C, Emans, Pieter J, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, Boonen, Annelies E R C H, van den Bemt, Bart J F, de Vries, Frank, Sub Pharmacotherapy, Theoretical, Sub Pharmacoepidemiology, Sub Gen. Pharmacoepi and Clinical Pharm, Pharmacoepidemiology and Clinical Pharmacology, Nielen, Johannes T H, Dagnelie, Pieter C, Emans, Pieter J, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, Boonen, Annelies E R C H, van den Bemt, Bart J F, and de Vries, Frank

Published
2016

10. Safety and efficacy of new oral anticoagulants and low-molecular-weight heparins compared with aspirin in patients undergoing total knee and hip replacements

Author

Apotheek Opleiding, Nielen, Johannes T H, Dagnelie, Pieter C, Emans, Pieter J, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, Boonen, Annelies E R C H, van den Bemt, Bart J F, de Vries, Frank, Apotheek Opleiding, Nielen, Johannes T H, Dagnelie, Pieter C, Emans, Pieter J, Veldhorst-Janssen, Nicole, Lalmohamed, Arief, van Staa, Tjeerd-Pieter, Boonen, Annelies E R C H, van den Bemt, Bart J F, and de Vries, Frank

Published
2016

11. Pharmacokinetics, analgesic effect, and tolerability of a single preprocedural dose of intranasal fentanyl in patients undergoing drain removal after breast reduction or augmentation surgery: A prospective, randomized, double-blind, placebo-controlled study

Author

Veldhorst-Janssen, Nicole M.L., Fiddelers, Audrey A.A., van der Kuy, Paul-Hugo M., Kessels, Alfons G.H., Theunissen, H. Maurice S., van der Hulst, René R.W.J., Neef, Cees, and Marcus, Marco A.E.

Published
2010
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