ArticleJournal of the American Heart Association2017
Temporal Trends in the Use and Comparative Effectiveness of Direct Oral Anticoagulant Agents Versus Warfarin for Nonvalvular Atrial Fibrillation: A Canadian Population-Based Study.
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 31 papers, 1 of them a synthesis that pooled it.
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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
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Telemedicine-Based Management of Oral Anticoagulation Therapy: Systematic Review and Meta-analysis.Journal of medical Internet research · 2023Pooled it
- Supporting anticoagulant treatment decision making to optimise stroke prevention in complex patients with atrial fibrillation: a cluster randomised trial.BMC family practice · 2020Trial
- Trial
- Oral anticoagulant switching in patients with atrial fibrillation: a long-term cohort study using population-level administrative data.International journal of clinical pharmacy · 2026Article
- Prescribing Practices, Polypharmacy, and Drug Interaction Risks in Anticoagulant Therapy: Insights from a Secondary Care Hospital.Journal of clinical medicine · 2026Article
- The association of anticoagulant use and hospitalization for hemorrhagic stroke among older adults aged 75 or older: A propensity score-matched study.Aging clinical and experimental research · 2025Article
- Circulating biomarkers and ischemic stroke risk in adults with atrial fibrillation taking anticoagulation: the Reasons for Geographic And Racial Differences in Stroke study.Journal of thrombosis and haemostasis : JTH · 2025Article
- Support for Thrombolytic Therapy for Acute Stroke Patients on Direct Oral Anticoagulants: Mortality and Bleeding Complications.The western journal of emergency medicine · 2024Article
- Initiation patterns of anticoagulants for atrial fibrillation among older UK adults with and without chronic kidney disease, 2010-2020.Open heart · 2024Article
- Anticoagulation Status and Left Atrial Appendage Occlusion Indications in Hospitalized Cardiology Patients with Atrial Fibrillation: A Hellenic Cardiorenal Morbidity Snapshot (HECMOS) Sub-Study.Medicina (Kaunas, Lithuania) · 2023Article
- Time Trends in Patient Characteristics, Anticoagulation Treatment, and Prognosis of Incident Nonvalvular Atrial Fibrillation in the Netherlands.JAMA network open · 2023Article
- Direct Oral Anticoagulants as the First Choice of Anticoagulation for Patients with Peripheral Artery Disease to Prevent Adverse Vascular Events: A Systematic Review and Meta-Analysis.Journal of cardiovascular development and disease · 2023Review
- Time trends in antithrombotic therapy prescription patterns: Real-world monocentric study in hospitalized patients with atrial fibrillation.World journal of cardiology · 2022Article
- Trends in Oral Anticoagulant Use Among 436 864 Patients With Atrial Fibrillation in Community Practice, 2011 to 2020.Journal of the American Heart Association · 2022Article
- Time Trends and Treatment Pathways in Prescribing Individual Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation: An Observational Study of More than Three Million Patients from Europe and the United States.International journal of clinical practice · 2022Observational
- Shifting from vitamin K antagonists to non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: predictors, patterns and temporal trends.BMC cardiovascular disorders · 2021Observational
- Article
- Predictors of preprocedural direct oral anticoagulant levels in patients having an elective surgery or procedure.Blood advances · 2020Article
- Prothrombin complex concentrates for DOAC-associated bleeding, global coagulation assays, and assessments of clinical hemostasis: How to gauge the impact?Research and practice in thrombosis and haemostasis · 2020Article
- Prevalence of Intracranial Injury in Adult Patients With Blunt Head Trauma With and Without Anticoagulant or Antiplatelet Use.Annals of emergency medicine · 2020Observational
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDirect oral anticoagulants (DOACs) are noninferior to warfarin for stroke prevention in atrial fibrillation (AF). We aimed to determine the population risk of stroke and death in incident AF, stratified by anticoagulation status and type, and the temporal trends of oral anticoagulation practice in the post-DOAC approval period. METHODS AND
resultsWe conducted a population-based cohort study of incident nonvalvular AF cases using administrative health data in Alberta, Canada. We used Cox proportional hazards modeling with anticoagulation status as a time-varying exposure and adjusted for age (continuous), sex, congestive heart failure, hypertension, diabetes mellitus, prior transient ischemic attack or ischemic stroke, myocardial infarction, peripheral artery disease, and chronic kidney disease. Primary outcome was the composite of stroke and death. Among 34 965 patients with incident AF (56.0% male, median age 73 years), relative to warfarin, DOAC use was associated with decreased risk of all stroke and death (hazard ratio: 0.90; 95% confidence interval, 0.83-0.97) and decreased hemorrhagic stroke (hazard ratio: 0.60; 95% confidence interval, 0.40-0.91]) but a similar risk of ischemic stroke (hazard ratio: 1.12; 95% confidence interval, 0.94-1.34]). During this time period, DOAC use increased rapidly, surpassing warfarin, but the total oral anticoagulation use in the population remained stable, even in the subgroup with the highest thromboembolic risk.
conclusionsIn a real-world population-based study of patients with incident AF, anticoagulation with DOACs was associated with decreased risk of stroke and death compared with warfarin. Despite a rapid uptake of DOACs in clinical practice, the total proportion of AF patients on anticoagulation has remained stable, even in high-risk patients.
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