Evidence map›Paper›PMID 30803288›Full record

ArticleJournal of the American Heart Association2019

Outcomes of Anticoagulation Therapy in Adults With Tetralogy of Fallot.

Alexander C Egbe, William R Miranda, Naser M Ammash, Venkata R Missula, Raja Jadav, Maria Najam, Srikanth Kothapalli, Heidi M Connolly

Open access · goldAbstract read
In one paragraph

Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 48% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Safety and Efficacy of DOAC Versus VKA in Adult Congenital Heart Disease: A Systematic Review and Meta-Analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
    Pooled it
  2. Outcomes of Anticoagulation Therapy in Adults With Tetralogy of Fallot.Journal of the American Heart Association · 2019
    Article
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 at 3 institutions in 1 country.

Alexander C Egbe1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
William R Miranda1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
Naser M Ammash1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
Venkata R Missula1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
Raja Jadav1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
Maria Najam1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
Srikanth Kothapalli1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
Heidi M Connolly1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.
Mayo Clinic in Arizona · USMayo Clinic · USMayo Clinic in Florida · US

Funding

Ventricular and Pulmonary Vascular Reserve after the Fontan OperationK23HL141448 · NHLBI · MAYO CLINIC ROCHESTER · PI EGBE, ALEXANDER · 2018 to 2021
$693k
NHLBI NIH HHS K23 HL141448
6 · The paper itself

Abstract

Background Available outcomes data for anticoagulation therapy in adults with congenital heart disease ( CHD ) provide assessment of global risk of this therapy for CHD patients (a heterogeneous population), but the risk of complications for the different CHD diagnoses is unknown. The purpose of the study was to describe the indications for anticoagulation, and the incidence and risk factors for major bleeding complication in adults with tetralogy of Fallot. Methods and Results We queried Mayo Adult Congenital Heart Disease (MACHD) database for tetralogy of Fallot patients (aged ≥18 years) that received anticoagulation, 1990-2017. Of 130 patients (42±14 years, 75 men [58%]), warfarin and direct oral anticoagulants were used in 125 (96%) and 5 (4%), respectively because atrial arrhythmias (n=109), mechanical prosthetic valve (n=29), intracardiac thrombus (n=4), pulmonary embolism (n=6), stroke (n=3), and perioperative anticoagulation (n=44). The median hypertension, abnormal renal or liver function; stroke; bleeding history or predisposition; labile international normalized ratio; elderly (>65 years); drug or alcohol use score for the entire cohort was 1 (0-2) and 27 (21%) had hypertension, abnormal renal or liver function; stroke; bleeding history or predisposition; labile international normalized ratio; elderly (>65 years); drug or alcohol use score ≥2. There were 14 minor bleeding events (1.6% per year) and 11 major bleeding events (1.3% per year) in 8 patients during median follow-up of 74 months (856 patient-years). Mechanical prosthesis (hazard ratio 1.78, CI 1.29-3.77, P=0.021) and hypertension, abnormal renal or liver function; stroke; bleeding history or predisposition; labile international normalized ratio; elderly (>65 years); drug or alcohol use score ≥2 (hazard ratio 1.41, CI 1.03-3.88, P=0.046) were risk factors for major bleeding events. All-cause mortality was higher in patients with major bleeding events (n=6, 75%) compared with patients without major bleeding events (n=25, 21%), P=0.001. Conclusions Considering the heterogeneity of the CHD population, data from the current study may be better suited for clinical decision-making in tetralogy of Fallot patients.

Indexed as

SurvivorsAdolescentAdultAnticoagulantsCardiovascular DiseasesCause of DeathDatabases, FactualFemaleHemorrhageHumansIncidenceMaleMiddle AgedPerioperative CareRetrospective StudiesRisk AssessmentAnticoagulantsanticoagulationbleedingstroketetralogy of Fallotthromboembolism

Identifiers

PMID30803288
PMCPMC6474918
OpenAlexW2916451403

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.