Short summary

Antithrombotic drugs are used by more than 500,000 Danes. At the same time, they are among the drugs most often associated with unintended events and serious side effects, most often in the form of dangerous and hospitalization-required bleeding. Concurrently, unintended use and lack thereof can lead to serious cardiovascular events. The purpose of this research project is to analyze the treatment needs, scope, and effect of antithrombotic drugs within different patient groups relevant to this.

Rationale

Antithrombotic drugs are used by more than 500,000 Danes. At the same time, they are among the drugs most often associated with unintended events and serious side effects, most often in the form of dangerous and hospitalization-required bleeding. Concurrently, unintended use and lack thereof can lead to serious cardiovascular events. The purpose of this research project is to analyze the treatment needs, scope, and effect of antithrombotic drugs within different patient groups relevant to this treatment. The focus will particularly be on thrombosis, bleeding, and other potential side effects. The project will investigate these aspects in various patient categories, including patients with atrial fibrillation, heart failure, thrombosis, venous thromboembolism, mechanical heart valves, peripheral arterial sclerosis, and cancer patients. The project is based on data from the Danish National Patient Registry and the Medicinal Product Statistics Register and will be combined with other administrative and clinical registers at Statistics Denmark. The collected data will be used to study the use of antithrombotic drugs in these patient groups focusing on consumption patterns, treatment intensities, treatment effectiveness, and occurrence of side effects as well as interactions with other medications. Studies based on this material will also illuminate how new drugs are implemented in daily practice, with the expectation that they should be at least as effective as existing treatments. The project will include a series of studies, including investigations of the latest class of direct oral anticoagulants (DOAC), introduced as an alternative to existing anticoagulant drugs in the last 10 years. Studies will also illuminate treatment scope and intensity as well as their consequences for treatment effectiveness in the individual patient. Socioeconomic factors will be considered, as they likely play a significant role in treatment indications and courses.

Description of the cohort

The study population will include all with prescriptions for antithrombotic treatment or those who can clinically be characterized with disorders where antithrombotic treatment is relevant.

Data and biological material

Patient groups are identified from diagnosis and procedure codes in the National Patient Register and supplemented with information from clinical quality databases. The morbidity of the patient groups will furthermore be compared with relevant subgroups of the full Danish population. Registers and Variable Content: The following registers will be used: The National Patient Registry, the Medicinal Product Statistics Register, the Central Person Registry, Socioeconomic Conditions, Danish Stroke Register, Register for Atrial Fibrillation in Denmark, Laboratory Database, and Hospital Medicine Register.

Collaborating researchers and departments

Department of Data and Research, Lillebælt Hospital (LH), Flemming Skjøth, lecturer, biostatistician, Ph.D.

Research Unit for Vascular Surgery (LH Kolding), Kim Christian Houlind, professor

Research Unit for Organ and Plastic Surgery (LH Vejle), Hans B Rahr, professor

Research Unit for Biochemistry and Immunology (LH Vejle), Ivan Brandslund, professor

Research Unit for Oncology (LH Vejle), Torben Frøstrup Hansen, professor

Research Unit for Neurology (LH Kolding), Henrik Boye Jensen, lecturer

Department of Thoracic Surgery (AUH, Aarhus), Thomas Decker Christensen, professor

Department of Ophthalmology (AAUH, Aalborg), Henrik Vorum, professor

Department of Ophthalmology (AUH, Aarhus), Toke Beck, professor