Evidence map›Paper›PMID 29786530›Full record

SynthesisCardiovascular revascularization medicine : including molecular interventions2019

Meta-analysis of safety and efficacy of oral anticoagulants in patients requiring catheter ablation for atrial fibrillation.

Hammad Rahman, Safi U Khan, Michael DePersis, Tehseen Hammad, Fahad Nasir, Edo Kaluski

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Cardiovascular revascularization medicine : including molecular interventions, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 46% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
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

6 authors at 4 institutions in 2 countries.

Hammad RahmanGuthrie Health System/ Robert Packer Hospital, Sayre, PA, USA. Electronic address: Hammad.Rahman@guthrie.org.
Safi U KhanGuthrie Health System/ Robert Packer Hospital, Sayre, PA, USA.
Michael DePersisGuthrie Health System/ Robert Packer Hospital, Sayre, PA, USA.
Tehseen HammadServices Hospital, Lahore, Pakistan.
Fahad NasirGuthrie Health System/ Robert Packer Hospital, Sayre, PA, USA.
Edo KaluskiGuthrie Health System/ Robert Packer Hospital, Sayre, PA, USA; Rutgers New Jersey Medical School, Newark, NJ, USA; The Geisinger Commonwealth Medical College, Scranton, PA, USA.
Guthrie Robert Packer Hospital · USSUNY Upstate Medical University · USCommonwealth Medical College · USServices Hospital · PK

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Sally Lynn Hodder · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundThe ideal oral anticoagulant agent during catheter ablation (CA) for atrial fibrillation (AF) remained unclear. HYPOTHESIS: Novel oral anticoagulants (NOACs) are safer and effective compared to uninterrupted vitamin K antagonists (U-VKA) among patients requiring CA for AF.

methodsFour randomized controlled trials (RCTs) and 9 observational studies (OS) were selected using PubMed/Medline, EMBASE and the CENTRAL data bases (Inception-December-2017). Estimates were reported as random effects risk ratio (RR) with 95% confidence interval (CI). The primary safety outcome was major bleeding and main efficacy endpoint was thromboembolism.

resultsIn RCTs restricted analysis, NOACs significantly reduced the relative risk of major bleeding by 72% compared to U-VKA (RR, 0.28, 95% CI, 0.14-0.58, P < 0.001). This significant effect was not achieved in OS based analysis (RR, 0.86, 95% CI, 0.42-1.78, P = 0.68). In terms of thromboembolism, both anticoagulation strategies were equally effective in analysis of RCTs (RR, 0.28, 95% CI, 0.05-1.70, P = 0.17) or OS (RR, 1.43, 95% CI, 0.46-4.39, P = 0.54). In sensitivity analysis, there was no difference among uninterrupted NOACs (U-NOACs) and U-VKA in terms of major bleeding [(RCTs: RR, 0.33, 95% CI, 0.10-1.06, P = 0.06); (OS: RR, 0.70, 95% CI, 0.28-1.78, P = 0.46)] or thromboembolism [(RCTs: RR, 0.25, 95% CI, 0.03-2.29, P = 0.22); (OS: RR, 0.68, 95% CI, 0.08-5.53, P = 0.72)].

conclusionNOACs, either interrupted or un-interrupted, are safer and equally effective drugs compared to U-VKA in AF patients requiring CA.

Indexed as

Catheter AblationAdministration, OralAgedAnticoagulantsAtrial FibrillationDrug Administration ScheduleFemaleHemorrhageHumansMaleMiddle AgedObservational Studies as TopicRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsThromboembolismAnticoagulantsAtrial fibrillationCatheter ablationNovel oral anti-coagulantsUninterrupted vitamin K antagonist

Identifiers

PMID29786530
PMCPMC7453962
OpenAlexW2801619646

What OpenQuestion holds

Textmetadata
LicenceTDM
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.