ReviewOpen heart
Direct oral anticoagulants versus warfarin: is new always better than the old?
Review in Open heart. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 45 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
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Anticoagulation quality through time in therapeutic range in Sub-Saharan Africa: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- The 2023 WSES guidelines on the management of trauma in elderly and frail patients.World journal of emergency surgery : WJES · 2024Guideline
- Implementation of genotype-guided dosing of warfarin with point-of-care genetic testing in three UK clinics: a matched cohort study.BMC medicine · 2019Trial
- Venous thromboembolism prophylaxis in multiple myeloma patients receiving immunomodulatory therapy: a systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2026Review
- Anticoagulant adherence and associated complications and readmissions in older valve surgery adults: insights from a retrospective cohort study.BMC geriatrics · 2026Article
- Genetic and Inflammatory Signatures Associated With Worse Prognosis in Hospitalized Patients With Severe SARS-CoV-2 Infection With and Without Diabetes.Journal of medical virology · 2025Article
- Comparison of medication adherence to different oral anticoagulants: population-based cohort study.BMJ open · 2023Article
- The efficacy and safety of direct factor Xa inhibitors versus vitamin K antagonists for atrial fibrillation in patients on hemodialysis: a meta-analysis of randomized controlled trials.Proceedings (Baylor University. Medical Center) · 2023Article
- Marine Biological Macromolecules and Chemically Modified Macromolecules; Potential Anticoagulants.Marine drugs · 2022Review
- Choice of oral anticoagulant prescribed by general practices in Wales: Application of Dirichlet regression and linked data.British journal of clinical pharmacology · 2022Article
- Implementation of a text messaging intervention to patients on warfarin therapy in Brazilian primary care units: a quasi-experimental study.BMC primary care · 2022Article
- Apixaban Use in Patients with Protein C and S Deficiency: A Case Series and Review of Literature.Journal of blood medicine · 2022Article
- Ethnic Diversity and Warfarin Pharmacogenomics.Frontiers in pharmacology · 2022Review
- Replacement of traditional prothrombin time monitoring with the new Fiix prothrombin time increases the efficacy of warfarin without increasing bleeding. A review article.Thrombosis journal · 2021Review
- Adherence to direct oral anticoagulant treatment for atrial fibrillation in the Netherlands: A surveillance study.Pharmacoepidemiology and drug safety · 2021Article
- Elderly people are inherently sensitive to the pharmacological activity of rivaroxaban: implications for DOAC prescribing.Journal of thrombosis and thrombolysis · 2021Article
- Pharmacogenomics in Cardiovascular Diseases.Current protocols · 2021Article
- Evaluation of point-of-care International Normalized Ratio in sickle cell disease.Research and practice in thrombosis and haemostasis · 2021Article
- Impact of adherence to warfarin therapy during 12 weeks of pharmaceutical care in patients with poor time in the therapeutic range.Journal of thrombosis and thrombolysis · 2021Article
- Updates in Anticoagulation Therapy Monitoring.Biomedicines · 2021Review
Corrections and comments
- Erratum issued
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
About 1.4 British million people are at risk of strokes due to non-valvular atrial fibrillation (AF) necessitating long-term anticoagulation. The vitamin K antagonist, warfarin, has a long half-life and narrow therapeutic range necessitating regular monitoring and is a common cause of iatrogenic hospital admission. Direct-acting oral anticoagulants (DOACs), dabigatran, rivaroxaban, apixaban and edoxaban are not required to have monitoring but are sensitive to changes in renal function and are associated with poorer adherence. There are good grounds to believe that DOACs are not always superior to warfarin in routine practice particularly with an older population. Much higher levels of therapeutic effectiveness can be achieved using a simple genotype guidance to identify those who are highly sensitive and by adoption of home monitoring. These adjustments could make warfarin the preferred drug for most people and would reduce the dramatic rise in health service expenditure.
Indexed as
Identifiers
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.