Antithrombotic regimens in patients with percutaneous coronary intervention whom an anticoagulant is indicated: A systematic review and network meta -analysis

Background: Patients undergoing percutaneous coronary intervention (PCI) who require anticoagulant therapy are at increased risk of bleeding. The optimal regimen for these patients is uncertain. This study aimed to compare safety and efficacy of antithrombotic regimens used in patients undergoing PCI with concomitant anticoagulant therapy. Methods: A systematic review and network meta-analysis was performed among studies comparing antithrombotic regimens for anticoagulated patients undergoing PCI. The primary outcome of interest was major bleeding. The secondary outcomes were coronary events. The reference intervention was classic triple therapy (aspirin plus clopidogrel plus VKA). Cluster rank incorporating risk (major bleeding) and benefit (all-cause death) was performed to identify the most appropriate regimen(s). Results: There were 3 RCTs (6 interventions) and 29 non-RCTs (8 interventions) that met the inclusion criteria with 22,179 patients. Network meta-analysis of RCTs indicated that dual therapy (DT), either with vitamin K antagonist (VKA) or direct anticoagulant (DOAC) plus an antiplatelet, significantly reduced the risk of major bleeding compared to triple therapy (TT) [pooled RR of 0.51 (0.30-0.87) and 0.68 (0.49-0.94), respectively]. In addition, VKA-DT significantly reduced the risk of all-cause death compared to TT [pooled RR of 0.40 (0.17-0.93)]. Results from network meta-analysis of non-RCT paralleled that of RCTs. No significant differences of coronary events were found. Conclusions: In conclusion, for anticoagulated patients undergoing PCI, dual therapy, either with warfarin or DOAC plus an antiplatelet, should be considered due to its optimal balance on efficacy and safety

Consumer willingness to pay for Chaiya organic salted egg in smart label packaging: the case study in Surat Thani province

Purpose – This research studies the factors influencing willingness to pay and to evaluate the value of willingness to pay for Chaiya organic salted egg in smart label packaging among consumers in Surat Thani province. Research methodology – The Conjoint Analysis method was used to analyse attribute factors based on literature reviews and related research. Data were collected through interviews and questionnaires from a consumer group aged 15 years and up, totalling 250 individuals. Findings – The results revealed that the attribute of the product with the greatest impact on consumer satisfaction is the certification seal for organic authenticity. This attribute would lead to an increasing price of approximately 1.35 USD per box. If Chaiya organic salted egg have modern packaging with a color bar indicating the salt level and an organic certification seal, the price level of Chaiya organic salted egg was two times higher than general Chaiya organic salted egg. Consumers were willing to pay the highest price at 7.46 USD per box. Research limitations – Having an excessive number of attribute sets may lead to confusion for interviewees when assigning scores to each set of attributes. Practical implications – Conjoint Analysis is a tool suitable for measuring customer satisfaction towards various product attributes and developing new products to introduce into the market. Originality/Value – the attribute of the product with the greatest impact on consumer satisfaction is the certification seal for organic authenticity