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dc.contributor.authorGue, Ying X
dc.contributor.authorKanji, Rahim
dc.contributor.authorWellsted, David M
dc.contributor.authorSrinivasan, Manivannan
dc.contributor.authorWyatt, Solange
dc.contributor.authorGorog, Diana A
dc.date.accessioned2020-01-07T01:07:55Z
dc.date.available2020-01-07T01:07:55Z
dc.date.issued2019-12-23
dc.identifier.citationGue , Y X , Kanji , R , Wellsted , D M , Srinivasan , M , Wyatt , S & Gorog , D A 2019 , ' Rationale and design of "Can Very Low Dose Rivaroxaban (VLDR) in addition to dual antiplatelet therapy improve thrombotic status in acute coronary syndrome (VaLiDate-R)" study : A randomised trial modulating endogenous fibrinolysis in patients with acute coronary syndrome ' , Journal of Thrombosis and Thrombolysis , pp. 1-7 . https://doi.org/10.1007/s11239-019-02014-5
dc.identifier.issn0929-5305
dc.identifier.otherPURE: 18538007
dc.identifier.otherPURE UUID: 61228149-77a8-45cc-915d-4b11c0f893cd
dc.identifier.otherPubMed: 31872349
dc.identifier.otherORCID: /0000-0001-5535-9430/work/67136741
dc.identifier.otherScopus: 85076879153
dc.identifier.urihttp://hdl.handle.net/2299/22041
dc.description© The Author(s) 2019. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
dc.description.abstractImpaired endogenous fibrinolysis is novel biomarker that can identify patients with ACS at increased cardiovascular risk. The addition of Very Low Dose Rivaroxaban (VLDR) to dual antiplatelet therapy has been shown to reduce cardiovascular events but at a cost of increased bleeding and is therefore not suitable for all-comers. Targeted additional pharmacotherapy with VLDR to improve endogenous fibrinolysis may improve outcomes in high-risk patients, whilst avoiding unnecessary bleeding in low-risk individuals. The VaLiDate-R study (ClinicalTrials.gov Identifier: NCT03775746, EudraCT: 2018-003299-11) is an investigator-initiated, randomised, open-label, single centre trial comparing the effect of 3 antithrombotic regimens on endogenous fibrinolysis in 150 patients with ACS. Subjects whose screening blood test shows impaired fibrinolytic status (lysis time > 2000s), will be randomised to one of 3 treatment arms in a 1:1:1 ratio: clopidogrel 75 mg daily (Group 1); clopidogrel 75 mg daily plus rivaroxaban 2.5 mg twice daily (Group 2); ticagrelor 90 mg twice daily (Group 3), in addition to aspirin 75 mg daily. Rivaroxaban will be given for 30 days. Fibrinolytic status will be assessed during admission and at 2, 4 and 8 weeks. The primary outcome measure is the change in fibrinolysis time from admission to 4 weeks follow-up, using the Global Thrombosis Test. If VLDR can improve endogenous fibrinolysis in ACS, future large-scale studies would be required to assess whether targeted use of VLDR in patients with ACS and impaired fibrinolysis can translate into improved clinical outcomes, with reduction in major adverse cardiovascular events in this high-risk cohort.en
dc.format.extent7
dc.language.isoeng
dc.relation.ispartofJournal of Thrombosis and Thrombolysis
dc.rightsOpen
dc.subjectAcute coronary syndrome
dc.subjectEndogenous fibrinolysis
dc.subjectNOAC
dc.subjectRivaroxaban
dc.subjectThrombosis
dc.subjectHematology
dc.subjectCardiology and Cardiovascular Medicine
dc.titleRationale and design of "Can Very Low Dose Rivaroxaban (VLDR) in addition to dual antiplatelet therapy improve thrombotic status in acute coronary syndrome (VaLiDate-R)" study : A randomised trial modulating endogenous fibrinolysis in patients with acute coronary syndromeen
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionSchool of Life and Medical Sciences
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85076879153&partnerID=8YFLogxK
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2019-12-23
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1007/s11239-019-02014-5
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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