ArticleCardiovascular therapeutics2015
Contraindications to anticoagulation therapy and eligibility for novel anticoagulants in older patients with atrial fibrillation.
Article in Cardiovascular therapeutics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- Left Atrial Appendage Closure Device With Delivery System: A Health Technology Assessment.Ontario health technology assessment series · 2017Pooled it
- Patients with perceived high-bleeding risk and computerized decision support for stroke prevention in atrial fibrillation: an AF-ALERT substudy : Piazza: outcomes of high-bleeding risk AF patients.Journal of thrombosis and thrombolysis · 2021Trial
- Supporting anticoagulant treatment decision making to optimise stroke prevention in complex patients with atrial fibrillation: a cluster randomised trial.BMC family practice · 2020Trial
- Review
- Antithrombotic therapy at the end-of-life-continue or stop?Research and practice in thrombosis and haemostasis · 2026Review
- Assessing Potential Benefit of Stroke Prophylaxis Therapy in Atrial Fibrillation and Atrial Flutter Using a Novel Competing Risk Scoring Tool.Journal of the American Heart Association · 2026Article
- Anticoagulation in Chronic Kidney Disease.Drugs · 2024Review
- Design and deployment of the STEEER-AF trial to evaluate and improve guideline adherence: a cluster-randomized trial by the European Society of Cardiology and European Heart Rhythm Association.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Real-world experience utilizing the nuvision 4D intracardiac echocardiography catheter for left atrial appendage closure.Scientific reports · 2024Observational
- Percutaneous left atrial appendage occlusion and risk of stroke, hospitalized bleeding and death in Medicare beneficiaries.Pharmacoepidemiology and drug safety · 2024Article
- Patient Characteristics Associated With Using Transcatheter Left Atrial Appendage Occlusion Versus Oral Anticoagulants for Atrial Fibrillation.Circulation. Cardiovascular quality and outcomes · 2024Article
- State-of-the-Art of Transcatheter Left Atrial Appendage Occlusion.Journal of clinical medicine · 2024Review
- A Comprehensive Review of Platelet-Rich Plasma and Its Emerging Role in Accelerating Bone Healing.Cureus · 2024Review
- Article
- Oral Anticoagulants and the Risk of Dementia in Patients With Nonvalvular Atrial Fibrillation: A Population-Based Cohort Study.Neurology · 2023Article
- Atrial fibrillation: trends in prevalence and antithrombotic prescriptions in the community.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2022Article
- Left atrial appendage occlusion is underutilized.Heart rhythm O2 · 2022Article
- Will Apple devices' passive atrial fibrillation detection prevent strokes? Estimating the proportion of high-risk actionable patients with real-world user data.Journal of the American Medical Informatics Association : JAMIA · 2022Observational
- Percutaneous Left Atrial Appendage Closure Using an Occluder Device: A Single Center Experience.Acta Cardiologica Sinica · 2022Article
- Quantifying the Impact of Atrial Fibrillation on Heart Failure-Related Patient-Reported Outcomes in the Utah mEVAL Program.Journal of cardiac failure · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
aimsOral anticoagulation therapy prevents stroke and improves survival in patients with atrial fibrillation, but the therapy is underutilized. We sought to identify the prevalence of contraindications for oral anticoagulation and the proportion of patients potentially eligible for different agents.
methodsWe identified patients with nonacute atrial fibrillation in a nationally representative 5% sample of 2009 Medicare data. We divided the population into patients ineligible for any oral anticoagulant, patients eligible for warfarin only, and patients eligible for any anticoagulant. We compared patient characteristics and the use of anticoagulation among the subgroups.
resultsAmong 86,671 patients with atrial fibrillation, 1872 (2.2%) were ineligible for anticoagulation because of an absolute contraindication, most frequently a history of intracranial hemorrhage (60%). Patients ineligible for any anticoagulant were the same age as the overall group (mean age, 80.5 vs. 80.4 years). However, they had higher rates of dementia (19% vs. 8.6%) and heart failure (59% vs. 43%) and higher mean CHADS2 scores (3.8 vs. 2.8). Of the remaining 84,799 patients eligible for anticoagulation, 7146 (8.4%) were eligible for warfarin only (most commonly because of mechanical heart valves [66%] and end-stage renal disease [12%]). Sixty-five percent of patients eligible for anticoagulation received warfarin, and the proportion was similar for patients with a relatively high risk of bleeding.
conclusionsOlder adults with atrial fibrillation rarely have absolute contraindications to oral anticoagulation therapy. Among patients without contraindications, most appeared to be eligible for any anticoagulant, and relatively high-risk features appeared not to influence warfarin use.
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Registered trials
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