Evidence map›Paper›PMID 30315487›Full record

ArticleCardiovascular drugs and therapy2018

Predictors of Major Bleeding Among Working-Age Adults with Atrial Fibrillation: Evaluating the Effects of Potential Drug-drug Interactions and Switching from Warfarin to Non-vitamin K Oral Anticoagulants.

Xue Feng, Usha Sambamoorthi, Kim Innes, Gregory Castelli, Traci LeMasters, Lianjie Xiong, Michael U Williams, Xi Tan

Abstract read
In one paragraph

Article in Cardiovascular drugs and therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A Systematic Review on Mobile Health Applications' Education Program for Patients Taking Oral Anticoagulants.International journal of environmental research and public health · 2021
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Observational
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

8 authors.

Xue FengDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Usha SambamoorthiDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Kim InnesDepartment of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA.
Gregory CastelliUniversity of Pittsburgh Medical Center (UPMC) St. Margaret, Pittsburgh, PA, USA.
Traci LeMastersDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
Lianjie XiongCollege of Pharmacy, California Health Sciences University, Clovis, CA, USA.
Michael U WilliamsDepartment of Medicine, San Antonio Military Medical Center, San Antonio, TX, USA.
Xi TanDepartment of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA. xntan@hsc.wvu.edu.

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Laura F. Gibson · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

purposeThis study aims to evaluate the associations between switching from warfarin to non-vitamin K oral anticoagulants (NOACs), exposure to potential drug-drug interactions (DDIs), and major bleeding events in working-age adults with atrial fibrillation (AF).

methodsWe conducted a retrospective cohort study using the claims database of commercially insured working-age adults with AF from 2010 to 2015. Switchers were defined as patients who switched from warfarin to NOAC; non-switchers were defined as those who remained on warfarin. We developed novel methods to calculate the number and proportion of days with potential DDIs with NOAC/warfarin. Multivariate logistic regressions were utilized to evaluate the associations between switching to NOACs, exposure to potential DDIs, and major bleeding events.

resultsAmong a total of 4126 patients with AF, we found a significantly lower number of potential DDIs and the average proportion of days with potential DDIs in switchers than non-switchers. The number of potential DDIs (AOR 1.14, 95% CI 1.02-1.27) and the HAS-BLED score (AOR 1.64, 95% CI 1.48-1.82) were significantly and positively associated with the likelihood of a major bleeding event. The proportion of days with potential DDIs was also significantly and positively associated with risk for bleeding (AOR 1.42, 95% CI 1.03, 1.96). We did not find significant associations between switching to NOACs and major bleeding events.

conclusionsThe number and duration of potential DDIs and patients' comorbidity burden are important factors to consider in the management of bleeding risk in working-age AF adults who take oral anticoagulants.

Indexed as

Drug SubstitutionAdministration, OralAdolescentAdultAnticoagulantsAtrial FibrillationDatabases, FactualDrug InteractionsFemaleHemorrhageHumansMaleMiddle AgedPolypharmacyRetrospective StudiesRisk AssessmentAnticoagulantsVitamin KWarfarinAtrial fibrillationBleedingDrug-drug interactionsNon-vitamin K oral anticoagulantsSwitching

Identifiers

PMID30315487
PMCPMC6468989

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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.