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Lemesle G, Bauters C, Bonello L, et al. Management of antithrombotics in situations with a gap in evidence: A national French survey focusing on patients with coronary artery disease and atrial fibrillation. Int J Cardiol. 2021;348:15-21doi: 10.1016/j.ijcard.2021.11.077.
Lemesle, G., Bauters, C., Bonello, L., Fauchier, L., Cayla, G., Marijon, E., Guenoun, M., Schurtz, G., Ninni, S., Richardson, M., Albert, F., Cohen, S., Lamblin, N., & Danchin, N. (2022). Management of antithrombotics in situations with a gap in evidence: A national French survey focusing on patients with coronary artery disease and atrial fibrillation. International journal of cardiology, 34815-21. https://doi.org/10.1016/j.ijcard.2021.11.077
Lemesle, Gilles, et al. "Management of antithrombotics in situations with a gap in evidence: A national French survey focusing on patients with coronary artery disease and atrial fibrillation." International journal of cardiology vol. 348 (2022): 15-21. doi: https://doi.org/10.1016/j.ijcard.2021.11.077
Lemesle G, Bauters C, Bonello L, Fauchier L, Cayla G, Marijon E, Guenoun M, Schurtz G, Ninni S, Richardson M, Albert F, Cohen S, Lamblin N, Danchin N. Management of antithrombotics in situations with a gap in evidence: A national French survey focusing on patients with coronary artery disease and atrial fibrillation. Int J Cardiol. 2022 Feb 01;348:15-21. doi: 10.1016/j.ijcard.2021.11.077. Epub 2021 Dec 03. PMID: 34864080.
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Int J Cardiol. 2022 Feb 01;348:15-21. doi: 10.1016/j.ijcard.2021.11.077. Epub 2021 Dec 03.

Management of antithrombotics in situations with a gap in evidence: A national French survey focusing on patients with coronary artery disease and atrial fibrillation.

International journal of cardiology

Gilles Lemesle, Christophe Bauters, Laurent Bonello, Laurent Fauchier, Guillaume Cayla, Eloi Marijon, Maxime Guenoun, Guillaume Schurtz, Sandro Ninni, Marjorie Richardson, Franck Albert, Serge Cohen, Nicolas Lamblin, Nicolas Danchin

Affiliations

  1. Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France; Univ. Lille, F-59000, France; Institut Pasteur of Lille, Inserm U1011, F-59000 Lille, France; FACT (French Alliance for Cardiovascular Trials), F-75000 Paris, France. Electronic address: [email protected].
  2. Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France; Institut Pasteur of Lille, Inserm U1167, F-59000 Lille, France; Univ. Lille, F-59000, France.
  3. Aix-Marseille Univ, Intensive care unit, Department of Cardiology, Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Centre for CardioVascular and Nutrition research (C2VN), INSERM 1263, INRA 1260, Marseille, France.
  4. Department of Cardiology, CHU de Trousseau, University François-Rabelais, 37170 Chambray-lès-, Tours, France.
  5. Department of Cardiology, University Hospital of Nîmes, 30000 Nîmes, France.
  6. Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France.
  7. Department of Cardiology, Hôpital Européen de Marseille, 13003 Marseille, France.
  8. Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France.
  9. Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France; Univ. Lille, F-59000, France; Institut Pasteur of Lille, Inserm U1011, F-59000 Lille, France; FACT (French Alliance for Cardiovascular Trials), F-75000 Paris, France.
  10. Department of Cardiology, Hospital of Chartres, 28000 Chartres, France.
  11. Department of Cardiology, Hôpital St Antoine, APHP, Paris, France.
  12. Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, FACT (French Alliance for Cardiovascular Trials), Paris, France.

PMID: 34864080 DOI: 10.1016/j.ijcard.2021.11.077

Abstract

BACKGROUND: If several randomized studies allowed to better apprehend what should be the best antithrombotic strategy in patients with concomitant coronary artery disease (CAD) and atrial fibrillation (AF), there are still several clinical situations with a gap of evidence.

METHODS: We conducted a national French survey in September-October 2020 among cardiologists in order to assess what are daily practices regarding the antithrombotic management in several specific clinical settings where no or little scientific evidence is available. The questionnaires were built by a committee of 6 cardiologists routinely involved in the field of CAD and/or AF.

RESULTS: Among the 6388 French cardiologists, 483 (7.6%) cardiologists participated to the survey. The rate of participation was rather homogeneous across the country. The mean age of participants was 48 +/- 12.7. There were 134 women (27.7%) and 349 men. Altogether, 181 (37.5%) cardiologists worked in private, 153 (31.7%) in non-universitary public and 83 (17.2%) in universitary public centers. The remaining had shared activity. Among the participants, 150 were interventional (coronary) cardiologists (31.1%). Others were general cardiologists (n = 229), specialists in the field of rhythmology (n = 43), heart failure (n = 17) or imaging (n = 44). The survey consisted of 10 questions pertaining to 2 virtual clinical scenarios.

CONCLUSIONS: The present survey is an illustration of how therapeutic decisions may vary in such situations with little or no scientific evidence. Such surveys may help experts to build consensus (answers with little variability) and to target the need for future trials and more research (answers with a lot of variability).

Copyright © 2021 Elsevier B.V. All rights reserved.

Keywords: Antiplatelet therapy; Atrial fibrillation; Coronary artery disease; Evidence-based medicine; Oral anticoagulation; Survey

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