Trial reportCirculation. Cardiovascular quality and outcomes2010
Warfarin discontinuation after starting warfarin for atrial fibrillation.
Trial report in Circulation. Cardiovascular quality and outcomes, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
66 citing papers in PubMed, 3 syntheses or guidelines pooled it, 187 citations in OpenAlex.
- Long-Term Persistence with Newly-Initiated Warfarin or Non-VKA Oral Anticoagulant (NOAC) in Patients with Non-Valvular Atrial Fibrillation: Insights from the Prospective China-AF Registry.Medical science monitor : international medical journal of experimental and clinical research · 2019Pooled it
- Improving the Efficiency and Quality of the Value Assessment Process for Companion Diagnostic Tests: The Companion test Assessment Tool (CAT).Journal of managed care & specialty pharmacy · 2015Pooled it
- Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and meta-analysis.BMC family practice · 2012Pooled it
- Safety and Outcomes of Concomitant Left Atrial Appendage Occlusion and Atrial Fibrillation Ablation.JACC. Advances · 2026Article
- Left atrial appendage occlusion after thromboembolic events or left atrial appendage sludge during anticoagulation therapy: Is two better than one? Real-world experience from a tertiary care hospital.Journal of arrhythmia · 2023Article
- Design and rationale of the mobile health intervention for rural atrial fibrillation.American heart journal · 2022Article
- Primary care provider payment models and adherence to anticoagulation in patients with atrial fibrillation.Journal of managed care & specialty pharmacy · 2021Article
- Risks associated with discontinuation of oral anticoagulation in newly diagnosed patients with atrial fibrillation: Results from the GARFIELD-AF Registry.Journal of thrombosis and haemostasis : JTH · 2021Article
- Methodological considerations for investigating oral anticoagulation persistence in atrial fibrillation.European heart journal. Cardiovascular pharmacotherapy · 2021Review
- World Café approach: exploring the future vision of oral anticoagulants for patients with atrial fibrillation (AF) in Ireland.BMJ open · 2020Article
- The Atrial Fibrillation Health Literacy Information Technology Trial: Pilot Trial of a Mobile Health App for Atrial Fibrillation.JMIR cardio · 2020Article
- Non-Vitamin K Oral Anticoagulants in Adults with Congenital Heart Disease: A Systematic ReviewJournal of clinical medicine · 2020Review
- A prospective survey of the persistence of warfarin or NOAC in nonvalvular atrial fibrillation: a COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF).The Korean journal of internal medicine · 2020Observational
- Persistence of oral anticoagulant treatment for atrial fibrillation in the Netherlands: A surveillance study.Research and practice in thrombosis and haemostasis · 2020Article
- Reducing Stroke Risk in Atrial Fibrillation: Adherence to Guidelines Has Improved, but Patient Persistence with Anticoagulant Therapy Remains Suboptimal.Korean circulation journal · 2019Review
- Article
- Early therapeutic persistence on dabigatran versus warfarin therapy in patients with atrial fibrillation: results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.Journal of thrombosis and thrombolysis · 2018Observational
- Warfarin for prevention of thromboembolism in atrial fibrillation: comparison of patient characteristics and outcomes of the "Real-World" Michigan Anticoagulation Quality Improvement Initiative (MAQIJournal of thrombosis and thrombolysis · 2018Article
- Real-World Health Care Costs Based on Medication Adherence and Risk of Stroke and Bleeding in Patients Treated with Novel Anticoagulant Therapy.Journal of managed care & specialty pharmacy · 2018Article
- Impact of Warfarin Persistence on Health-Care Utilization and Costs Among Patients With Atrial Fibrillation Managed in Anticoagulation Clinics in the United States.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2018Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAlthough warfarin is widely recommended to prevent atrial fibrillation-related thromboembolism, many eligible patients do not take warfarin. The objective of this study was to describe factors associated with warfarin discontinuation in patients newly starting warfarin for atrial fibrillation. METHODS AND
resultsWe identified 4188 subjects newly starting warfarin in the Anticoagulation and Risk Factors in Atrial Fibrillation Study and tracked longitudinal warfarin use through pharmacy and laboratory databases. Data on patient characteristics, international normalized ratio (INR) tests, and incident hospitalizations for hemorrhage were obtained from clinical and laboratory databases. Multivariable Cox regression analysis was used to identify independent predictors of prolonged warfarin discontinuation, defined as ≥180 consecutive days off warfarin. Within 1 year after warfarin initiation, 26.3% of subjects discontinued therapy despite few hospitalizations for hemorrhage (2.3% of patients). The risk of discontinuation was higher in patients aged <65 years (adjusted hazard ratio [HR], 1.33 [95% CI, 1.03 to 1.72] compared to those aged ≥85 years), patients with poorer anticoagulation control (HR, 1.46 [95% CI, 1.42 to 1.49] for every 10% decrease in time in therapeutic INR range), and patients with lower stroke risk (HR, 2.54 [95% CI, 1.86 to 3.47] for CHADS(2) stroke risk index of 0 compared to 4 to 6).
conclusionsMore than 1 in 4 patients newly starting warfarin for atrial fibrillation discontinued therapy in the first year despite a low overall hemorrhage rate. Individuals deriving potentially less benefit from warfarin, including those with younger age, fewer stroke risk factors, and poorer INR control, were less likely to remain on warfarin. Maximizing the benefits of anticoagulation for atrial fibrillation depends on determining which patients are most appropriately initiated and maintained on therapy.
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What OpenQuestion holds
Registered trials
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.