Evidence map›Paper›PMID 23996149›Full record

SynthesisBMJ (Clinical research ed.)2013

Efficacy and safety outcomes of oral anticoagulants and antiplatelet drugs in the secondary prevention of venous thromboembolism: systematic review and network meta-analysis.

Lana A Castellucci, Chris Cameron, Grégoire Le Gal, Marc A Rodger, Doug Coyle, Philip S Wells, Tammy Clifford, Esteban Gandara, George Wells, Marc Carrier

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 19 pooled it
18.2field-weighted citation impact, top 1% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 19 syntheses or guidelines pooled it, 189 citations in OpenAlex.

  1. Statins for adults with a first episode of venous thromboembolic disease.The Cochrane database of systematic reviews · 2026
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  6. Antiplatelet agents for the treatment of deep venous thrombosis.The Cochrane database of systematic reviews · 2022
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  7. Guideline
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5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Lana A CastellucciThrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada K1H 8L6.
Chris Cameron
Grégoire Le Gal
Marc A Rodger
Doug Coyle
Philip S Wells
Tammy Clifford
Esteban Gandara
George Wells
Marc Carrier
University of Ottawa · CACanadian Agency for Drugs and Technologies in Health · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo summarise and compare the efficacy and safety of various oral anticoagulants (dabigatran, rivaroxaban, apixaban, and vitamin K antagonists) and antiplatelet agents (acetylsalicylic acid) for the secondary prevention of venous thromboembolism.

designSystematic review and network meta-analysis. DATA SOURCES: Literature search using Medline (1950 to present), Embase (1980 to present), and the Cochrane Register of Controlled Trials using the OVID interface. Publications from potentially relevant journals were also searched by hand. REVIEW

methodsRandomised controlled trials of patients receiving anticoagulants, antiplatelet drugs, or placebo or observation for secondary prevention of venous thromboembolism. Selected outcomes were rates of recurrent venous thromboembolism and major bleeding. Two reviewers independently extracted data onto standardised forms.

results12 articles met our inclusion criteria, with 11,999 patients evaluated for efficacy and 12,167 for safety. All treatments reduced the risk of recurrent venous thromboembolism. Compared with placebo or observation, vitamin K antagonists at a standard adjusted dose (target international normalised ratio 2.0-3.0) showed the highest risk difference (odds ratio 0.07; 95% credible interval 0.03 to 0.15) and acetylsalicylic acid showed the lowest risk difference (0.65; 0.39 to 1.03). Risk of major bleeding was higher with a standard adjusted dose of vitamin K antagonists (5.24; 1.78 to 18.25) than with placebo or observation. Fatal recurrent venous thromboembolism and fatal bleeding were rare. Detailed subgroup and individual patient level data were not available.

conclusionsAll oral anticoagulants and antiplatelet agents investigated in this analysis were associated with a reduced recurrence of venous thromboembolism compared with placebo or observation, although acetylsalicylic acid was associated with the lowest risk reduction. Vitamin K antagonists given at a standard adjusted dose was associated with the greatest risk reduction in recurrent venous thromboembolism, but also the greatest risk of major bleeding.

Indexed as

AnticoagulantsAspirinBenzimidazolesbeta-AlanineDabigatranHemorrhageHumansMorpholinesPlatelet Aggregation InhibitorsPyrazolesPyridonesRecurrenceRivaroxabanThiophenesVenous ThromboembolismVitamin KAnticoagulantsapixabanAspirinBenzimidazolesbeta-AlanineDabigatranMorpholinesPlatelet Aggregation InhibitorsPyrazolesPyridonesRivaroxabanThiophenesVitamin K

Identifiers

PMID23996149
PMCPMC3758108
OpenAlexW2007680892

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.