SynthesisPloS one2015
Risk of Fatal Bleeding in Episodes of Major Bleeding with New Oral Anticoagulants and Vitamin K Antagonists: A Systematic Review and Meta-Analysis.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Prothrombin complex concentrate for reversal of oral anticoagulants in patients with oral anticoagulation-related critical bleeding: a systematic review of randomised clinical trials.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Pooled it
- Drug interactions with apixaban: A systematic review of the literature and an analysis of VigiBase, the World Health Organization database of spontaneous safety reports.Pharmacology research & perspectives · 2020Pooled it
- The Reversal of Bleeding Caused by New Oral Anticoagulants (NOACs): A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2018Pooled it
- Cost-Effectiveness of Anticoagulation Treatment for Subclinical Device-Detected Atrial Fibrillation.JAMA network open · 2026Article
- Estimating the Stroke Risk Threshold for Initiating Non-Vitamin K Antagonist Oral Anticoagulation in Atrial Fibrillation: Markov Decision Model Analysis.Circulation. Cardiovascular quality and outcomes · 2025Article
- Net Benefit of Anticoagulation in Subclinical Device-Detected Atrial Fibrillation.JAMA network open · 2025Article
- Factor XI Inhibitors: perspectives in primary and secondary prevention of ischemic stroke.Internal and emergency medicine · 2024Review
- Article
- Mansoor's Self-Report Tool for Cardiovascular Risk Assessment predicts adverse in-hospital events in patients with pulmonary embolism.The clinical respiratory journal · 2023Article
- Selection of Non-vitamin K Antagonist Oral Anticoagulant for Stroke Prevention in Atrial Fibrillation Based on Patient Profile: Perspectives from Vietnamese Experts. Part 1.European cardiology · 2023Review
- Role of Direct Oral Anticoagulation Agents as Thromboprophylaxis in Antiphospholipid Syndrome.Cureus · 2021Review
- Comparison of high- and low-dose 4-factor prothrombin complex concentrate for the emergent reversal of oral Factor Xa inhibitors.Journal of thrombosis and thrombolysis · 2021Article
- Characteristics, Location, and Clinical Outcomes of Gastrointestinal Bleeding in Patients Taking New Oral Anticoagulants Compared to Vitamin K Antagonists.Journal of clinical medicine · 2021Article
- Article
- Article
- Length of hospitalization and mortality for bleeding during treatment with warfarin, dabigatran, or rivaroxaban.PloS one · 2018Article
- Direct-Acting Oral Anticoagulants: Practical Considerations for Emergency Medicine Physicians.Emergency medicine international · 2016Review
- Choosing Non-Vitamin K Antagonist Oral Anticoagulants: Practical Considerations We Need to Know.Ochsner journal · 2016Review
- The New 3D Printed Left Atrial Appendage Closure with a Novel Holdfast Device: A Pre-Clinical Feasibility Animal Study.PloS one · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe reversibility of new/novel oral anticoagulants (NOAC) is not well understood, whereas the reversal strategies for bleeding associated with vitamin k antagonists (VKA), such as warfarin, is well established. It is unknown whether outcomes are different between bleeds occurring with NOAC compared to VKA use.
objectivesThis systematic review and meta-analysis of randomized controlled trials determines the relative odds of fatal bleeding given that a patient suffered a major bleed while on NOAC versus VKA therapy. SEARCH
methodsData on major and fatal bleeding events was sought from randomized controlled trials of NOAC agents compared to VKAs. MAIN
results20 trials were included in the meta-analysis. From which, 4056 first-time, major bleeding events were reported and included in the primary analysis. The summary odds ratio for the conditional odds of fatal bleeding given that a major bleeding event occurred was 0.65 [0.52, 0.81] favoring the NOAC agents (p = 0.0001). The reduced odds of fatal bleeding with NOACs was not demonstrated after controlling for bleeding location. Given that an intracranial bleeding event occurred, the summary odds ratio for the conditional odds of fatal bleeding was 0.96 [0.70, 1.32]. For extracranial bleeding events, the summary odds ratio was also statistically insignificant at 0.945 [0.66, 1.35]. AUTHOR’S
conclusionsThe odds ratio calculated in this meta-analysis showed a reduced odds of death in major bleeding associated with NOAC use. This risk reduction was due to a disproportionate amount of intracranial bleeding in the VKA arms. For any given bleeding site, there was no evidence of a significant difference in fatal outcomes from bleeds associated with NOAC versus VKA use. PROTOCOL REGISTRATION: Protocol registered on PROSPERO under CRD42014013294.
Indexed as
Identifiers
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.