Evidence map›Paper›PMID 36208909›Full record

ArticleEuropean heart journal. Cardiovascular pharmacotherapy2023

Antithrombotic therapy following revascularization for chronic limb-threatening ischaemia: a European survey from the ESC Working Group on Aorta and Peripheral Vascular Diseases.

Marco De Carlo, Oliver Schlager, Lucia Mazzolai, Marianne Brodmann, Christine Espinola-Klein, Daniel Staub, Victor Aboyans, Henrik Sillesen, Sebastian Debus, Maarit Venermo and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal. Cardiovascular pharmacotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 11 institutions in 8 countries.

Marco De CarloCardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy.ORCID 0000-0002-5763-9804
Oliver SchlagerDivision of Angiology, 2nd Department of Medicine, Medical University of Vienna, 1090 Vienna, Austria.ORCID 0000-0001-6934-5355
Lucia MazzolaiDivision of Angiology, Heart and Vessel department, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland.ORCID 0000-0001-9650-3822
Marianne BrodmannDivision of Angiology, Medical University Graz, 8036 Graz, Austria.
Christine Espinola-KleinSection Angiology, Department of Cardiology, Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany.ORCID 0000-0001-9243-1761
Daniel StaubDivision of Angiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland.
Victor AboyansDepartment of Cardiology, Dupuytren University Hospital, and INSERM 1094 & IRD 270, University of Limoges, 87042 Limoges, France.ORCID 0000-0002-0322-9818
Henrik SillesenDepartment of Vascular Surgery, Rigshospitalet, University of Copenhagen, and Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark.ORCID 0000-0002-3302-6288
Sebastian DebusDepartment of Vascular Medicine, University Heart Centre Hamburg, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany.ORCID 0000-0002-5664-6439
Maarit VenermoDepartment of Vascular Surgery, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland.ORCID 0000-0001-8814-0988
Jill BelchThe Institute of Cardiovascular Research, University of Dundee, DD19SY Dundee, Ninewells, Scotland, UK.ORCID 0000-0001-8280-6689
Mauro FerrariCardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy.
Raffaele De CaterinaCardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy.ORCID 0000-0003-1637-574X
Azienda Ospedaliera Universitaria Pisana · ITInserm · FRJohannes Gutenberg University Mainz · DEMedical University of Graz · ATMedical University of Vienna · ATUniversität Hamburg · DEUniversity Hospital of Lausanne · CHUniversity of Basel · CHUniversity of Copenhagen · DKUniversity of Dundee · GBUniversity of Helsinki · FI

Funding

AmgenBayerBoehringer IngelheimDaiichi Sankyo CompanySanofi
6 · The paper itself

Abstract

aimsChronic limb-threatening ischaemia (CLTI) entails dismal outcomes and is an absolute indication to lower extremity revascularization (LER) whenever possible. Antithrombotic therapy is here crucial, but available evidence on best strategies (choice of drugs, combinations, duration) is scarce. We conducted a European internet-based survey on physicians' use of antithrombotic therapy after revascularization for CLTI, under the aegis of the ESC Working Group on Aorta and Peripheral Vascular Disease in collaboration with other European scientific societies involved in CLTI management and agreeing to send the survey to their affiliates. METHODS AND

results225 respondents completed the questionnaire. Antithrombotic therapy following surgical/endovascular LER varies widely across countries and specialties, with dedicated protocols reported only by a minority (36%) of respondents. Dual antiplatelet therapy with aspirin and clopidogrel is the preferred choice for surgical (37%) and endovascular (79%) LER. Dual pathway inhibition (DPI) with aspirin and low-dose rivaroxaban is prescribed by 16% of respondents and is tightly related to the availability of reimbursement (OR 6.88; 95% CI 2.60-18.25) and to the choice of clinicians rather than of physicians performing revascularization (OR 2.69; 95% CI 1.10-6.58). A ≥ 6 months-duration of an intense (two-drug) postprocedural antithrombotic regimen is more common among surgeons than among medical specialists (OR 2.08; 95% CI 1.10-3.94). Bleeding risk assessment is not standardised and likely underestimated.

conclusionCurrent antithrombotic therapy of CLTI patients undergoing LER remains largely discretional, and prescription of DPI is related to reimbursement policies. An individualised assessment of thrombotic and bleeding risks is largely missing.

Indexed as

Endovascular ProceduresPeripheral Arterial DiseaseAortaAspirinChronic Limb-Threatening IschemiaFibrinolytic AgentsHumansSurveys and QuestionnairesTreatment OutcomeAspirinFibrinolytic AgentsAntithrombotic therapyChronic limb-threatening ischaemiaDual pathway inhibitionLower-extremity artery diseasePeripheral revascularizationVascular surgery

Identifiers

PMID36208909
PMCPMC12375865
OpenAlexW4303685776

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.