Evidence map›Paper›PMID 22949490›Full record

ArticleCirculation. Cardiovascular quality and outcomes2012

National trends in oral anticoagulant use in the United States, 2007 to 2011.

Kate Kirley, Dima M Qato, Rachel Kornfield, Randall S Stafford, G Caleb Alexander

4 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 150 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
150citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04247919 terminatednot on this mapstarted 2020, after this paper: background citation

Investigation of Genetic Variations on Patients With Adverse Drug Events While on Direct Oral Anticoagulants (DOACs)

TypeobservationalSponsorCipherome, Inc.Ran2020 to 2020Enrolled3ConditionsDrug-Related Side Effects and Adverse Reactions
NCT04580589 completednot on this mapstarted 2021, after this paper: background citation

Investigation of Genetic Variations on Patients With Adverse Events While on Direct Oral Anticoagulants (DOACs)

TypeobservationalSponsorCipherome, Inc.Ran2021 to 2022Enrolled210ConditionsDrug-Related Side Effects and Adverse Reactions, Treatment Failure
NCT04597593 completednot on this mapstarted 2020, after this paper: background citation

Correlation Between Bleeding Complication and Treatment Failure of DOAC and Its Predictions Based on Cipherome's Pharmacogenomic Technology

TypeobservationalSponsorCipherome, Inc.Ran2020 to 2022Enrolled200ConditionsDrug-Related Side Effects and Adverse Reactions, Iatrogenic Disorder
NCT05632445 phase4completednot on this mapstarted 2019, after this paper: background citation

Antithrombotic Therapy After Left Atrial Appendage Occlusion: Double Antiplatelet Therapy vs Apixaban

TypeinterventionalSponsorDR. XAVIER FREIXARan2019 to 2022Enrolled160ConditionsLeft Atrial Appendage OcclusionArmsApixaban vs. DAPT
3 · Its place in the literature

Who cites it

150 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. Effects of pre-operative continuing oral anticoagulants or antiplatelets on health outcomes among older patients with hip fracture: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
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90 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kate KirleyDepartment of Family Medicine, University of Chicago, Chicago, IL, USA.
Dima M Qato
Rachel Kornfield
Randall S Stafford
G Caleb Alexander

Funding

Translating Clinical Decision Making into Systems of Care: A Mid-Career MentorK24HL086703 · NHLBI · STANFORD UNIVERSITY · PI STAFFORD, RANDALL SCOTT · 2007 to 2016
$1.5M
AHRQ HHS R01 HS0189960NHLBI NIH HHS K24 HL086703
6 · The paper itself

Abstract

backgroundLittle is known regarding the adoption of direct thrombin inhibitors in clinical practice. We examine trends in oral anticoagulation for the prevention of thromboembolism in the United States. METHODS AND

resultsWe used the IMS Health National Disease and Therapeutic Index, a nationally representative audit of office-based providers, to quantify patterns of oral anticoagulant use among all subjects and stratified by clinical indication. We quantified oral anticoagulant expenditures using the IMS Health National Prescription Audit. Between 2007 and 2011, warfarin treatment visits declined from ≈2.1 million (M) quarterly visits to ≈1.6M visits. Dabigatran use increased from 0.062M quarterly visits (2010Q4) to 0.363M visits (2011Q4), reflecting its increasing share of oral anticoagulant visits from 3.1% to 18.9%. In contrast to warfarin, the majority of dabigatran visits have been for atrial fibrillation, though this proportion decreased from 92% (2010Q4) to 63% (2011Q4), with concomitant increases in dabigatran's off-label use. Among atrial fibrillation visits, warfarin use decreased from 55.8% visits (2010Q4) to 44.4% (2011Q4), whereas dabigatran use increased from 4.0% to 16.9%. Of atrial fibrillation visits, the fraction not treated with any oral anticoagulants has remained unchanged at ≈40%. Expenditures related to dabigatran increased rapidly from $16M in 2010Q4 to $166M in 2011Q4, exceeding expenditures on warfarin ($144M) in 2011Q4.

conclusionsDabigatran has been rapidly adopted into ambulatory practice in the United States, primarily for treatment of atrial fibrillation, but increasingly for off-label indications. We did not find evidence that it has increased overall atrial fibrillation treatment rates.

Indexed as

Administration, OralAgedAged, 80 and overAmbulatory CareAnticoagulantsAntithrombinsAtrial FibrillationBenzimidazolesbeta-AlanineDabigatranDrug CostsDrug PrescriptionsDrug UtilizationDrug Utilization ReviewGuideline AdherenceHealth Care SurveysAnticoagulantsAntithrombinsBenzimidazolesbeta-AlanineDabigatranWarfarin

Identifiers

PMID22949490
PMCPMC3490619

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.