Thrombus - 2011

Should antiplatelet therapy be individualised?
Marie Lordkipanidzé and Gillian Lowe
pp 1-4
Antiplatelet agents are an essential part of therapy, both in treatment and in prevention of acute ischaemic events. Despite the overwhelming evidence in support of the efficacy of aspirin and clopidogrel in patients with cardiovascular diseases, the medical community is divided on the issue of possible resistance to antiplatelet drugs, a concept that surfaced 20 years ago and remains a matter of open debate to this day.

Comment: FDA approval for dabigatran in non-valvular atrial fibrillation
Peter Rose
pp 2-2
Administration (FDA) approved the marketing of dabigatran etexilate for the prevention of stroke and systemic embolisation in patients with non-valvular atrial fibrillation (AF). This represents the first new oral anticoagulant in 50 years for stroke prevention in AF. It is, therefore, to be hoped that similar approval will follow soon in the UK. The approval was based on the results of the RE-LY trial published in 2009. This was a large open label, randomised trial in which dabigatran was compared with warfarin (target international normalised ratio [INR] 2–3) in over 18,000 patients.

Examining the evidence for self-monitoring and self-management of oral anticoagulation
Tracy Tai and Carl Heneghan
pp 9-10
Many medical conditions lead to thromboembolic events, including cardiovascular causes such as atrial fibrillation (AF) or mechanical heart valve insertion, and respiratory causes such as pulmonary embolism. Oral anticoagulation therapy with vitamin K antagonists reduces these events. Warfarin is the main oral vitamin K antagonist anticoagulation therapy in the UK. Aspirin is also recommended by the National Institute for Health and Clinical Excellence (NICE) in its clinical guideline.

Commissioning thromboprophylaxis: why it is important in primary care
Jim Gardner
pp 11-14
This article considers the importance of commissioning thromboprophylaxis from a primary care perspective. It looks at broad commissioning themes consistent with the Institute for Healthcare Improvement’s TripleAim approach and it illustrates data from a single primary care trust in the north west of England.

Reader survey: What you told us about Thrombus

pp 15-15
In Thrombus 14.2 we issued a reader survey to help us gauge exactly how readers are using the journal, and also how helpful a resource it is for those working within the relevant fields. Approximately a quarter of those who responded were consultant haematologists, with the rest being a mix of specialist registrars in haematology, GPs, pharmacists, cardiologists, specialist nurses, and nurse practitioners.