Evidence map›Paper›PMID 28736385›Full record

ArticleJournal of the American Heart Association2017

Thromboembolic Risk, Bleeding Outcomes and Effect of Different Antithrombotic Strategies in Very Elderly Patients With Atrial Fibrillation: A Sub-Analysis From the PREFER in AF (

Giuseppe Patti, Markus Lucerna, Ladislav Pecen, Jolanta M Siller-Matula, Ilaria Cavallari, Paulus Kirchhof, Raffaele De Caterina

Open access · goldAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 5 pooled it
15.7field-weighted citation impact, top 1% of its field
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

74 citing papers in PubMed, 5 syntheses or guidelines pooled it, 169 citations in OpenAlex.

  1. Pooled it
  2. Meta-analysis of Safety and Efficacy of Anticoagulation versus no Anticoagulation in Octogenarians and Nonagenarians with Atrial Fibrillation.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2021
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14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 5 countries.

Giuseppe PattiDepartment of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Italy g.patti@unicampus.it rdecater@unich.it.
Markus LucernaDaiichi Sankyo Europe, Munich, Germany.
Ladislav PecenInstitute of Informatics, Academy of Sciences of Czech Republic, Prague, Czech Republic.
Jolanta M Siller-MatulaDepartment of Cardiology, Medical University of Vienna, Austria.
Ilaria CavallariDepartment of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Italy.
Paulus KirchhofInstitute of Cardiovascular Sciences, University of Birmingham, United Kingdom.
Raffaele De CaterinaG. d'Annunzio University of Chieti and Center of Excellence on Aging CeSI-Met, Chieti, Italy g.patti@unicampus.it rdecater@unich.it.
Università Campus Bio-Medico · ITCzech Academy of Sciences · CZDaiichi Sankyo (Germany) · DEMedical University of Vienna · ATUniversity of Birmingham · GBUniversity of Chieti-Pescara · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncreasing age predisposes to both thromboembolic and bleeding events in patients with atrial fibrillation; therefore, balancing risks and benefits of antithrombotic strategies in older populations is crucial. We investigated 1-year outcome with different antithrombotic approaches in very elderly atrial fibrillation patients (age ≥85 years) compared with younger patients. METHODS AND

resultsWe accessed individual patients' data from the prospective PREFER in AF (PREvention oF thromboembolic events-European Registry in Atrial Fibrillation), compared outcomes with and without oral anticoagulation (OAC), and estimated weighed net clinical benefit in different age groups. A total of 6412 patients, 505 of whom were aged ≥85 years, were analyzed. In patients aged <85 years, the incidence of thromboembolic events was 2.8%/year without OAC versus 2.3%/year with OAC (0.5% absolute reduction); in patients aged ≥85 years, it was 6.3%/year versus 4.3%/year (2% absolute reduction). In very elderly patients, the risk of major bleeding was higher than in younger patients, but similar in patients on OAC and in those on antiplatelet therapy or without antithrombotic treatment (4.0%/year versus 4.2%/year;

conclusionsBecause the risk of stroke increases with age more than the risk of bleeding, the absolute benefit of OAC is highest in very elderly patients, where it, by far, outweighs the risk of bleeding, with the greatest net clinical benefit in such patients.

Indexed as

Administration, OralAgedAged, 80 and overAge FactorsAnticoagulantsAtrial FibrillationClinical Decision-MakingEuropeFemaleFibrinolytic AgentsHemorrhageHumansIncidenceIschemic Attack, TransientMalePatient SelectionAnticoagulantsFibrinolytic AgentsPlatelet Aggregation Inhibitorsanticoagulationatrial fibrillationmajor bleedingthromboembolic eventsvery elderly

Identifiers

PMID28736385
PMCPMC5586290
OpenAlexW2739440077

What OpenQuestion holds

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Registered trials

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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.