Observational studyJournal of the American Heart Association2016
Effectiveness and Safety of Dabigatran, Rivaroxaban, and Apixaban Versus Warfarin in Nonvalvular Atrial Fibrillation.
Observational study in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 182 papers, 12 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
182 citing papers in PubMed, 12 syntheses or guidelines pooled it, 413 citations in OpenAlex.
- Switching from Vitamin K Antagonists to Direct Oral Anticoagulants in Frail Elderly Patients with Atrial Fibrillation: Systematic Review and Meta-Analysis.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Dose-Response Efficacy and Safety of Factor XI/XIa Inhibitors in Atrial Fibrillation; a Systematic Review and Meta-Analysis With Subgroup Exploration and Trial Sequential Validation.Clinical cardiology · 2026Pooled it
- Efficacy and safety of different antithrombotic treatment regimens in patients undergoing transcatheter mitral valve repair and atrial fibrillation; A meta-analysis and systematic review.Frontiers in cardiovascular medicine · 2026Pooled it
- Factor XI/XIa inhibitors versus direct oral anticoagulants in atrial fibrillation with stroke risk: a GRADE-assessed meta-analysis of randomized controlled trials.Naunyn-Schmiedeberg's archives of pharmacology · 2025Pooled it
- 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
- Effectiveness and Safety of Dose-Specific DOACs in Patients With Atrial Fibrillation: A Systematic Review and Network Meta-Analysis.Cardiovascular therapeutics · 2025Pooled it
- Anticoagulant drugs for patients with atrial fibrillation on dialysis: a systematic analysis and network meta-analysis.Frontiers in pharmacology · 2023Pooled it
- Effectiveness and Safety of Dabigatran Compared to Vitamin K Antagonists in Non-Asian Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis.Clinical drug investigation · 2021Pooled it
- Cost-Effectiveness of Direct Non-Vitamin K Oral Anticoagulants Versus Vitamin K Antagonists for the Management of Patients with Non-Valvular Atrial Fibrillation Based on Available "Real-World" Evidence: The Italian National Health System Perspective.Clinical drug investigation · 2021Pooled it
- Pooled it
- Guideline
- Bleeding outcomes associated with rivaroxaban and dabigatran in patients treated for atrial fibrillation: a systematic review and meta-analysis.BMC cardiovascular disorders · 2017Pooled it
- Risk of intracranial hemorrhage (RICH) in users of oral antithrombotic drugs: Nationwide pharmacoepidemiological study.PloS one · 2018Trial
- Comparative risk of major bleeding with new oral anticoagulants (NOACs) and phenprocoumon in patients with atrial fibrillation: a post-marketing surveillance study.Clinical research in cardiology : official journal of the German Cardiac Society · 2017Trial
- [Determinants of bleeding risk in anticoagulated patients in primary care: A retrospective observational study].Atencion primaria · 2026Article
- Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced CKD Not Requiring Dialysis.JAMA network open · 2026Article
- Real-World Bleeding Outcomes Among Hospitalized Patients Receiving Apixaban or Rivaroxaban: A Single-Center Retrospective Cohort Study.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Prevention of Gastrointestinal Bleeding in Patients Receiving Direct Oral Anticoagulants: A Narrative Review and Practical Framework for Prescribers.Clinics and practice · 2026Review
- Utilization of Apixaban Pharmacokinetics for Dose Optimization in High-Risk Elderly Patients.Clinical pharmacokinetics · 2026Observational
- Incidence and outcomes of major bleeding among first-time oral factor Xa inhibitor users: multinational observational cohort studies.Research and practice in thrombosis and haemostasis · 2026Article
122 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe introduction of non-vitamin K antagonist oral anticoagulants has been a major advance for stroke prevention in atrial fibrillation; however, outcomes achieved in clinical trials may not translate to routine practice. We aimed to evaluate the effectiveness and safety of dabigatran, rivaroxaban, and apixaban by comparing each agent with warfarin. METHODS AND
resultsUsing a large US insurance database, we identified privately insured and Medicare Advantage patients with nonvalvular atrial fibrillation who were users of apixaban, dabigatran, rivaroxaban, or warfarin between October 1, 2010, and June 30, 2015. We created 3 matched cohorts using 1:1 propensity score matching: apixaban versus warfarin (n=15 390), dabigatran versus warfarin (n=28 614), and rivaroxaban versus warfarin (n=32 350). Using Cox proportional hazards regression, we found that for stroke or systemic embolism, apixaban was associated with lower risk (hazard ratio [HR] 0.67, 95% CI 0.46-0.98, P=0.04), but dabigatran and rivaroxaban were associated with a similar risk (dabigatran: HR 0.98, 95% CI 0.76-1.26, P=0.98; rivaroxaban: HR 0.93, 95% CI 0.72-1.19, P=0.56). For major bleeding, apixaban and dabigatran were associated with lower risk (apixaban: HR 0.45, 95% CI 0.34-0.59, P<0.001; dabigatran: HR 0.79, 95% CI 0.67-0.94, P<0.01), and rivaroxaban was associated with a similar risk (HR 1.04, 95% CI 0.90-1.20], P=0.60). All non-vitamin K antagonist oral anticoagulants were associated with a lower risk of intracranial bleeding.
conclusionsIn patients with nonvalvular atrial fibrillation, apixaban was associated with lower risks of both stroke and major bleeding, dabigatran was associated with similar risk of stroke but lower risk of major bleeding, and rivaroxaban was associated with similar risks of both stroke and major bleeding in comparison to warfarin.
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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.