Guideline topic: Antithrombotic therapy
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1 Guideline topic: Antithrombotic therapy General comments Search coverage Guidelines Websites with relevant guidelines: Agency for Health Care Research and Quality (AHRQ) ASERNIP-S SERNIPSPublications/default.htm Canadian Medical Association Centre for Clinical Effectiveness (Australia) Health Technology Assessment NHS Centre for Reviews and Dissemination NHS Quality Improvement Scotland National Institute for Clinical Excellence (NICE) National Electronic Library for Health National Guideline Clearinghouse National Health and Medical Research Council (NHMRC) New Zealand Guidelines Group PRODIGY Knowledge Swedish Council on Technology Assessment in Health Care (SBU) TRIP Database Databases covered: Total hits: 41 Systematic reviews Terms for antithrombotics were combined with thrombosis and embolism terms then the reviews search filter was applied. Databases covered: Medline, Embase, CINAHL, PsycINFO, Cochrane, AMED Total hits: 2270 Sifted result: 422 Split into 2 by date: refs refs Dates covered:
2 Medline search strategy 1. exp Anticoagulants/ 2. exp Thrombolytic Therapy/ 3. exp Platelet Aggregation Inhibitors/ 4. exp Fibrinolytic Agents/ 5. anticoagulant$.tw. 6. thrombolytic$.tw. 7. antiplatelet$.tw. 8. fibrinolytic$.tw. 9. antithrombotic$.tw. 10. or/ exp "embolism and thrombosis"/ 12. thrombosis.tw. 13. thromboembolism.tw. 14. embolism.tw. 15. emboli.tw. 16. or/ and 16 RCTs Databases covered: Medline, Embase, CINAHL, PsycINFO, Cochrane Dates covered and results: see table below Observational studies/ Searches without filter Databases covered: Medline, Embase, CINAHL, PsycINFO Dates covered and results: see table below Supplementary searches Databases covered: Medline, Embase, CINAHL, PsycINFO, Cochrane Dates covered:
3 Search strategies The following are listings of the main Medline strategies used for this guideline. All conventions and symbols are from the Ovid implementation of Medline. Strategies used in other databases were substantially the same, though different terminology may have been used to take account of different thesauri used in non- Medline databases. Search filters were added to identify studies of a particular type (systematic review, RCT etc.) Listings of the search filters used by SIGN can be found on the SIGN Web site. Generic Stem: Medline 1. exp Anticoagulants/ 2. exp Thrombolytic Therapy/ 3. exp Platelet Aggregation Inhibitors/ 4. exp Fibrinolytic Agents/ 5. anticoagulant$.tw. 6. thrombolytic$.tw. 7. antiplatelet$.tw. 8. fibrinolytic$.tw. 9. antithrombotic$.tw. 10. or/1-9 Embase (Search terms limited to focussed EmTree terms) 1. exp *Anticoagulant Agent/ 2. exp *Anticoagulant Therapy/ 3. exp *Antithrombocytic Agent/ 4. exp *Fibrinolytic Agent/ 5. exp *Fibrinolytic Therapy/ 6. or/1-5 Scope of searches for RCTs and observational studies KQ Type of studies Date range Initial recall Sifted result 1 RCT (drug eluting Observational stents) 2 RCT RCT RCT RCT All (no filter) All (no filter) All (no filter) All (no filter)
4 15 All (no filter) Medline Search strategies used for specific key questions: KQ 1 1. exp Platelet Aggregation Inhibitors/ 2. antiplatelet*.tw. 3. aspirin*.tw. 4. acetylsalicylic acid*.tw. 5. exp Dipyridamole/ 6. dipyridamole*.tw. 7. clopidogrel*.tw. 8. thiopyridine*.tw. 9. or/ exp Myocardial Infarction/ 11. myocardial infarction*.tw. 12. MI.tw. 13. or/ and 13 KQ 1 (Drug eluting stents) 1. exp Platelet Aggregation Inhibitors/ 2. antiplatelet*.tw. 3. aspirin*.tw. 4. acetylsalicylic acid*.tw. 5. exp Dipyridamole/ 6. dipyridamole*.tw. 7. clopidogrel*.tw. 8. thiopyridine*.tw. 9. or/ exp Drug-Eluting Stents/ 11. drug eluting stent*.tw. 12. des.tw. 13. or/ and 13 KQ 2 1. exp Heparin/ or exp Heparin, Low-Molecular-Weight/ 4
5 2. heparin*.tw. 3. heparin*.tw. 4. (UFH* or LMWH*).tw. 5. (enoxaparin* or bemiparin* or dalteparin* or nadroparin* or parnaparin* or reviparin* or tinzaparin*).mp. [mp=title, original title, abstract, name of substance word, subject heading word] 6. fondaparinux*.tw. 7. danaparoid*.tw. 8. or/ ((cardiac or heart) and thromboembol*).tw. 10. (coronary and thromboembol*).tw. 11. exp Ischemia/ 12. (ischemia or ischaemia).tw. 13. peripheral arterial bypass.mp. 14. exp Peripheral Vascular Diseases/ 15. exp Plasmapheresis/ 16. (plasmapheresis or plasmaphoresis).tw. 17. or/ and exp Angioplasty/ 20. angioplast*.tw. 21. exp Renal Dialysis/ or exp Hemofiltration/ 22. (hemodialysis or haemodialysis or hemofiltration or haemofiltration).tw. 23. exp Catheterization/ 24. catheter*.tw. 25. or/ or/ and and 8 KQ 4 1. exp Thrombolytic Therapy/ 2. Fibrinolytic Agents/ 3. thrombolysis.tw. 4. thrombolytic.tw. 5. exp Streptokinase/ 6. streptokinase*.tw. 7. exp Tissue Plasminogen Activator/ 8. alteplase*.tw. 9. exp Urokinase-Type Plasminogen Activator/ 10. urokinase*.tw. 5
6 11. reteplase*.tw. 12. tenecteplase*.tw. 13. or/ exp Peripheral Vascular Diseases/ 15. peripheral arter*.tw. 16. exp Arteriovenous Fistula/ 17. exp Arteriovenous Shunt, Surgical/ 18. (arteriovenous and (fistula* or shunt*)).tw. 19. exp Catheterization/ 20. catheter*.tw. 21. or/ and 21 KQ 9 1. exp dabigatran/ or exp dabigatran etexilate/ 2. dabigatran*.tw. 3. exp Rivaroxaban/ 4. rivaroxaban*.tw. 5. exp Lepirudin/ 6. lepirudin*.tw. 7. exp Hirulog/ 8. bivalirudin*.tw. 9. or/1-8 KQ exp Aspirin/ 2. aspirin*.tw. 3. exp Thrombolytic Therapy/ 4. thrombolytic*.tw. 5. or/ exp Warfarin/ 7. warfarin*.tw. 8. exp Heparin/ or exp Heparin, Low-Molecular-Weight/ 9. heparin*.tw. 10. or/ and 10 6
7 KQ exp Pregnancy/ 2. exp Pregnancy Complications/ 3. pregnan*.tw. 4. exp Fetus/ 5. (fetus or fetal).tw. 6. maternal.tw. 7. exp Prenatal Care/ 8. exp Postnatal Care/ 9. (antenatal or prenatal or postnatal).tw. 10. exp Abnormalities, Drug-Induced/ 11. teratogenicit*.tw. 12. or/1-11 KQ exp Anticoagulants/ 2. exp Thrombolytic Therapy/ 3. exp Platelet Aggregation Inhibitors/ 4. exp Fibrinolytic Agents/ 5. anticoagulant$.tw. 6. thrombolytic$.tw. 7. antiplatelet$.tw. 8. fibrinolytic$.tw. 9. antithrombotic$.tw. 10. or/ exp Drug Interactions/ 12. exp Food-Drug Interactions/ 13. exp Phytotherapy/ 14. exp Nonprescription Drugs/ 15. exp Contraceptive Agents/ 16. exp Alcoholic Beverages/ 17. or/ and 17 KQ (bridg* adj5 therapy).tw. 2. exp Preoperative Care/ 3. exp Perioperative Care/ 7
8 4. exp Intraoperative Care/ 5. exp Postoperative Care/ 6. (preoperativ* or perioperativ* or intraoperativ* or postoperativ*).tw. 7. (cessation or interrupt* or uninterrupt* or discontinu* or withheld or withhold*).tw. 8. or/1-7 KQ exp Hemorrhage/ 2. (hemorrhag* or haemorrhag*).tw. 3. bleed*.tw. 4. revers*.tw. 5. or/ and 5 KQ exp Anticoagulants/ 2. anticoagulant*.tw. 3. exp Heparin/ 4. exp Warfarin/ 5. heparin*.tw. 6. warfarin*.tw. 7. or/ exp Point-of-Care Systems/ 9. (point of care or point-of-care).tw. 10. exp Decision Making, Computer-Assisted/ 11. exp Decision Support Systems, Clinical/ 12. (computer* adj5 decision).tw. 13. (computer-assisted or computer assist*).tw. 14. decision support.tw. 15. exp Patient Satisfaction/ 16. (patient adj (satisfaction or preference)).tw. 17. exp Patient Care Management/ 18. or/ and 18 8
9 Medline Search strategies used for supplementary searches: Atrial Fibrillation 1. exp Atrial Fibrillation/ 2. atrial fibrillation*.tw. 3. or/ exp Warfarin/ 5. warfarin*.tw. 6. exp Aspirin/ 7. aspirin*.tw. 8. or/ and 8 Cardiac Disease 1. exp Heart Diseases/ 2. ((heart or cardiac) adj3 (failure* or disease*)).tw. 3. rheumatic mitral valve disease.tw. 4. (mitral adj3 stenosis).tw. 5. (mitral adj3 prolapse).tw. 6. mitral annular calcification.tw. 7. (aortic adj3 disease).tw. 8. cardiomyopath*.tw. 9. (heart adj3 valve*).tw. 10. or/ exp Warfarin/ 12. warfarin*.tw. 13. exp Aspirin/ 14. aspirin*.tw. 15. dabigatran*.tw. 16. rivaroxaban*.tw. 17. or/ and 17 9
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