Evidence map›Paper›PMID 29668889›Full record

SynthesisEuropean heart journal2018

Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials.

Harsh B Golwala, Christopher P Cannon, Ph Gabriel Steg, Gheorghe Doros, Arman Qamar, Stephen G Ellis, Jonas Oldgren, Jurrien M Ten Berg, Takeshi Kimura, Stefan H Hohnloser and 2 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European heart journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 8 pooled it
22.7field-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

72 citing papers in PubMed, 8 syntheses or guidelines pooled it, 163 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. A systematic review of randomized trials comparing double versus triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2020
    Pooled it
  7. Pooled it
  8. Antithrombotic therapy in atrial fibrillation: stop triple therapy and start optimizing dual therapy?Clinical research in cardiology : official journal of the German Cardiac Society · 2020
    Pooled it
  9. Trial
  10. Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025
    Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Article
  16. 2023 European Society of Cardiology guidelines for the management of acute coronary syndromes : Statement of endorsement by the NVVC.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024
    Review
  17. Review
  18. Article
  19. Atrial fibrillation de novo in acute coronary syndrome.Archivos de cardiologia de Mexico · 2024
    Review
  20. Article

12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 7 countries.

Harsh B GolwalaBrigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, 75 Francis Street Boston, MA 02115, USA.
Christopher P CannonBrigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, 75 Francis Street Boston, MA 02115, USA.
Ph Gabriel StegFACT, French Alliance for Cardiovascular Trials; Hôpital Bichat, AP-HP; Université Paris-Diderot; and INSERM U-1148, Paris, France.
Gheorghe DorosBaim Institute for Clinical Research, 930 Commonwealth Ave#3, Boston, MA 02215, USA.
Arman QamarBrigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, 75 Francis Street Boston, MA 02115, USA.
Stephen G EllisDepartment of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.
Jonas OldgrenUppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Akademiska sjukhuset, Ing.40, 5 tr, Uppsala 75185, Sweden.
Jurrien M Ten BergDepartment of Cardiology, St. Antonius Hospital Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein, Netherlands.
Takeshi KimuraDepartment of Cardiovascular Medicine, Kyoto University Hospital, 54 Shogoin Kawaharacho, Sakyo Ward, Kyoto, Kyoto Prefecture 606-8507, Japan.
Stefan H HohnloserDepartment of Cardiology, Division of Cardiac Electrophysiology, Johann Wolfgang Goethe University, Building 23 C, Theodor Stern Kai 7, 60590 Frankfurt, Germany.
Gregory Y H LipInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham B 12 7QH, UK.
Deepak L BhattBrigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, 75 Francis Street Boston, MA 02115, USA.
Brigham and Women's Hospital · USBaim Institute for Clinical Research · USCleveland Clinic · USGoethe University Frankfurt · DEHarvard University · USKyoto University Hospital · JPSt. Antonius Ziekenhuis · NLUniversité Paris Cité · FRUniversity of Birmingham · GBUppsala University Hospital · SE

Funding

TRAINING PROGRAM IN CARDIOVASCULAR RESEARCHT32HL007604 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MARK W FEINBERG · 1985 to 2026
$19.0M
NHLBI NIH HHS T32 HL007604
6 · The paper itself

Abstract

Aims: Of patients with atrial fibrillation (AF), approximately 10% undergo percutaneous coronary intervention (PCI). We studied the safety and efficacy of dual vs. triple antithrombotic therapy (DAT vs. TAT) in this population. Methods and results: A systematic review and meta-analysis was conducted using PubMed, Embase, EBSCO, Cochrane database of systematic reviews, Web of Science, and relevant meeting abstracts for Phase 3, randomized trials that compared DAT vs. TAT in patients with AF following PCI. Four trials including 5317 patients were included, of whom 3039 (57%) received DAT. Compared with the TAT arm, Thrombolysis in Myocardial Infarction (TIMI) major or minor bleeding showed a reduction by 47% in the DAT arm [4.3% vs. 9.0%; hazard ratio (HR) 0.53, 95% credible interval (CrI) 0.36-0.85, I2 = 42.9%]. In addition, there was no difference in the trial-defined major adverse cardiac events (MACE) (10.4% vs. 10.0%, HR 0.85, 95% CrI 0.48-1.29, I2 = 58.4%), or in individual outcomes of all-cause mortality, cardiac death, myocardial infarction, stent thrombosis, or stroke between the two arms. Conclusion: Compared with TAT, DAT shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of MACE. Our findings support the concept that DAT may be a better option than TAT in many patients with AF following PCI.

Indexed as

Percutaneous Coronary InterventionAtrial FibrillationClinical Trials, Phase III as TopicDrug Therapy, CombinationFibrinolytic AgentsHemorrhageHumansRandomized Controlled Trials as TopicThromboembolismFibrinolytic Agents

Identifiers

PMID29668889
PMCPMC5951099
OpenAlexW2802512131

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.