Evidence map›Paper›PMID 28526929›Full record

ArticleCardiology and therapy2017

Analytical Management of Patients Undergoing Oral Anticoagulant Therapy Could Have a Strong Impact on Clinical Outcomes: A Follow-up Study.

Vincenzo De Iuliis, Sebastiano Ursi, Gianfranco Vitullo, Irma Griffo, Antonio Marino, Marika Caruso, Francesco Cipollone, Sabrina Capodifoglio, Veronica Breda, Elena Toniato and 3 more

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Article in Cardiology and therapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Vincenzo De IuliisCHIETI, SS Annunziata University Hospital, ASL Lanciano-Vasto-Chieti, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Sebastiano UrsiCHIETI, SS Annunziata University Hospital, ASL Lanciano-Vasto-Chieti, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Gianfranco VitulloCHIETI, SS Annunziata University Hospital, ASL Lanciano-Vasto-Chieti, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Irma GriffoCHIETI, SS Annunziata University Hospital, ASL Lanciano-Vasto-Chieti, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Antonio MarinoCHIETI, SS Annunziata University Hospital, ASL Lanciano-Vasto-Chieti, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Marika CarusoDepartment of Medical, Oral and Biotechnological Sciences, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Francesco CipolloneDepartment of Medicine and Science of Aging, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Sabrina CapodifoglioDepartment of Medical, Oral and Biotechnological Sciences, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Veronica BredaDepartment of Medical, Oral and Biotechnological Sciences, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Elena ToniatoDepartment of Medical, Oral and Biotechnological Sciences, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy. e.toniato@unich.it.
Alfonso PennelliDepartment of Medical, Oral and Biotechnological Sciences, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Pio ContiDepartment of Medical, Oral and Biotechnological Sciences, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.
Stefano MartinottiCHIETI, SS Annunziata University Hospital, ASL Lanciano-Vasto-Chieti, University of Chieti, Via dei Vestini 31, 66100, Chieti, CH, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOral anticoagulant therapy, such as vitamin K antagonists (VKAs), is prominent for the prevention of cerebral ischemic stroke or systemic embolism and all-cause mortality in patients with atrial fibrillation, venous thromboembolism, and mechanical or biological valve. VKA treatment requires monitoring of the international normalized ratio (INR) in order to maintain it in a therapeutic range, avoiding side effects, the main and most significant of which is bleeding. The aim of the present study was to evaluate the event rates of several clinical composite outcomes, such as bleeding, thromboembolic events, and all-cause death.

methodsWe compared three organizational models distinguished by a total (from 1 January to 31 December 2015 in which PT/INR analysis with the relative internal and external quality controls was performed by the surveillance center) or partial (from 15 January to 15 July 2016 and from 15 August to 15 November 2016, in which the surveillance center had the ability to view only the PT/INR results or all patients analyses, including blood count, creatinine, liver enzymes, etc., respectively) analytical patient management. The present longitudinal follow-up study included 1225 patients, recruited from 1 January 2015 to 15 November 2016 at a surveillance center for the prevention of cerebral ischemic stroke and systemic embolism in Chieti (Italy).

resultsThe results show a significant rise of the incidence rate ratio in patients undergoing VKA treatment during the period 15 January to 15 July 2016 compared to the previous one regarding total bleeding, especially for minor bleeding and digestive bleeding; thromboembolic events; and all-death cause.

conclusionsThese findings show that analytical and clinical data and information should be under the direct supervision and responsibility of the surveillance center. In fact, this approach seems to highlight the best results in terms of safety and therapeutic effectiveness.

Indexed as

Atrial fibrillationBleeding riskClinical outcomesOral anticoagulant

Identifiers

PMID28526929
PMCPMC5688967

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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.