ReviewDrugs & aging2016
Minimizing the Risk of Bleeding with NOACs in the Elderly.
Review in Drugs & aging, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Impact of direct oral anticoagulant off-label doses on clinical outcomes of atrial fibrillation patients: A systematic review.British journal of clinical pharmacology · 2020Pooled it
- Elderly Bleeding Risk of Direct Oral Anticoagulants in Nonvalvular Atrial Fibrillation: A Systematic Review and Meta-Analysis of Cohort Studies.Drugs in R&D · 2019Pooled it
- Effect of Danhong injection on pharmacokinetics and pharmacodynamics of rivaroxaban in rats.Naunyn-Schmiedeberg's archives of pharmacology · 2025Article
- Prevalence and factors associated with inappropriate dosing of apixaban and rivaroxaban in hospitalized older adults with atrial fibrillation: a cross-sectional study.Drugs & aging · 2024Article
- Management and Outcomes of Pulmonary Embolism in the Oldest-Old.International journal of general medicine · 2024Article
- Nonvitamin K oral anticoagulants with proton pump inhibitor cotherapy ameliorated the risk of upper gastrointestinal bleeding.Scientific reports · 2023Article
- XGBoost-based machine learning test improves the accuracy of hemorrhage prediction among geriatric patients with long-term administration of rivaroxaban.BMC geriatrics · 2023Article
- Chinese expert consensus on antithrombotic management of high-risk elderly patients with chronic coronary syndrome.Aging medicine (Milton (N.S.W)) · 2023Article
- Review
- Oral anticoagulation patterns and prognosis in octogenarian patients with atrial fibrillation.Journal of thrombosis and thrombolysis · 2022Article
- Patterns in anticoagulant utilization in the Czech Republic during 2007-2017.Journal of thrombosis and thrombolysis · 2019Article
- Sex-differences in post-discharge outcomes among patients hospitalized for atrial fibrillation.Clinical cardiology · 2019Article
- [Anticoagulation in geriatric patients with atrial fibrillation : With what and for whom no more?]Herz · 2018Review
- Prescribing of NOACs has outnumbered warfarin: exploring how physicians choose anticoagulant treatments.European journal of clinical pharmacology · 2018Article
- Review
- [New oral anticoagulants for prophylaxis of stroke : Results of an expert conference on practical use in geriatric patients].Zeitschrift fur Gerontologie und Geriatrie · 2016Article
- Factors influencing the use of direct oral anticoagulants among patients with chronic chagas cardiomyopathy.Archivos peruanos de cardiologia y cirugia cardiovascularArticle
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 at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Novel oral anticoagulants (NOACs) such as dabigatran, rivaroxaban, apixaban and edoxaban have gained a lot of popularity as alternatives to warfarin for anticoagulation in various clinical settings. However, there is conflicting opinion regarding the absolute benefit of NOAC use in elderly patients. Low body mass, altered body composition of fat and muscle, renal impairment and concurrent presence of multiple comorbidities predispose elderly patients to many adverse effects with NOACs that are typically not seen in younger patients. There have been reports that NOAC use, in particular dabigatran, is associated with a higher risk of gastrointestinal bleeding in the elderly. Diagnosis and management of NOAC-associated bleeding in the elderly is difficult due to the absence of commonly available drug-specific antidotes that can rapidly reverse the anticoagulant effects. Moreover, in elderly patients, a number of factors such as the presence of other comorbid medical conditions, renal insufficiency, drug interactions from polypharmacy, risk of falls and dementia need to be considered before prescribing anticoagulation therapy. Elderly patients frequently have compromised renal function, and therefore dose adjustments according to creatinine clearance for NOACs need to be made. As each NOAC comes with its own unique advantages and safety profile, an individualized case by case approach should be adopted to decide on the appropriate anticoagulation regimen for elderly patients after weighing the overall risks and benefits of therapy.
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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.