ArticleStroke2014
Intracranial hemorrhage mortality in atrial fibrillation patients treated with dabigatran or warfarin.
Article in Stroke, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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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
19 citing papers in PubMed.
- Equivalent inpatient mortality among direct-acting oral anticoagulant and warfarin users presenting with major hemorrhage.Thrombosis research · 2020Trial
- Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010-2017.European stroke journal · 2021Article
- Anticoagulants in Older Patients with Nonvalvular Atrial Fibrillation after Intracranial Hemorrhage.Journal of stroke · 2019Article
- Outcomes of Hemorrhagic Stroke Patients with Atrial Fibrillation or Flutter.Journal of atrial fibrillation · 2019Article
- Exploring the effect of factor Xa inhibitors on rotational thromboelastometry: a case series of bleeding patients.Journal of thrombosis and thrombolysis · 2019Article
- All-Cause Mortality Risk with Direct Oral Anticoagulants and Warfarin in the Primary Treatment of Venous Thromboembolism.Thrombosis and haemostasis · 2018Article
- Comparing intracerebral hemorrhages associated with direct oral anticoagulants or warfarin.Neurology · 2018Article
- Incidence and characteristics of major bleeding among rivaroxaban users with renal disease and nonvalvular atrial fibrillation.Clinical and experimental emergency medicine · 2018Article
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- The Anticoagulated trauma patient in the age of the direct oral anticoagulants: a Canadian perspective.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Article
- Oral anticoagulants for stroke prevention in patients with atrial fibrillation and previous intracranial hemorrhage.Internal and emergency medicine · 2017Article
- Intracranial hemorrhage during administration of a novel oral anticoagulant.Journal of rural medicine : JRM · 2016Article
- Dabigatran-Associated Intracranial Hemorrhage: Literature Review and Institutional Experience.The Neurohospitalist · 2015Review
- Traumatic fatal cerebral hemorrhage in an old patient with a history of multiple sclerosis under dabigatran: a case report and review of the literature.Journal of geriatric cardiology : JGC · 2015Article
- Bleeding complications from the direct oral anticoagulants.BMC hematology · 2015Article
- Secondary stroke prevention: challenges and solutions.Vascular health and risk management · 2015Review
- Misclassification in administrative claims data: quantifying the impact on treatment effect estimates.Current epidemiology reports · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
background and purposeIn randomized trials, patients with atrial fibrillation (AF) receiving dabigatran, a direct oral anticoagulant, had lower risk of intracranial bleeding (ICB) than those on warfarin. However, concerns exist about potential worse outcomes in dabigatran users if bleeding occurs, given the lack of approved reversal agents. Thus, we examined in-hospital mortality in AF patients with ICB being treated with dabigatran versus warfarin in a real-world population in the United States.
methodsWe analyzed healthcare utilization claims in the Truven Health Marketscan Research Databases. The study sample included patients with AF admitted to a hospital with a primary diagnosis of ICB. Information on medications, inpatient, and outpatient diagnoses was obtained from available claims. Propensity score-adjusted risk ratios and 95% confidence intervals of in-hospital mortality comparing current users of dabigatran versus warfarin were estimated using relative risk regression.
resultsAmong 2391 AF patients admitted with ICB (2290 on warfarin, 101 on dabigatran), 531 died during their admission. In-hospital mortality was similar in those treated with warfarin (22%) or dabigatran (20%). Compared with warfarin users, the propensity score-adjusted risk ratio (95% confidence interval) of mortality in dabigatran users was 0.93 (0.62-1.37). Associations were similar across different ICB subtypes (intracerebral hemorrhage, subarachnoid hemorrhage, and subdural hematoma).
conclusionsIn this sample of AF patients with ICB on oral anticoagulants, dabigatran was not associated with higher in-hospital mortality compared with warfarin. Hence, reluctance to use dabigatran because of a lack of approved reversal agents is not supported by our results.
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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.