Evidence map›Paper›PMID 31015222›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2019

Thromboembolic and haemorrhagic events in patients with atrial fibrillation: a prospective cohort study in UK primary and secondary care.

John Robson, Rohini Mathur, Marian Priebe, Zaheer Ahmed, Luis Ayerbe

Open access · bronzeAbstract read
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Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

5 authors at 1 institution in 1 country.

John RobsonCentre for Primary Care and Public Health, Barts, and the London School of Medicine and Dentistry, Queen Mary University of London, London.
Rohini MathurCentre for Primary Care and Public Health, Barts, and the London School of Medicine and Dentistry, Queen Mary University of London, London.
Marian PriebeCentre for Primary Care and Public Health, Barts, and the London School of Medicine and Dentistry, Queen Mary University of London, London.
Zaheer AhmedCentre for Primary Care and Public Health, Barts, and the London School of Medicine and Dentistry, Queen Mary University of London, London.
Luis AyerbeBarts, and the London School of Medicine and Dentistry, Queen Mary University of London, London; research fellow, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge.
Queen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStrong evidence on the long-term safety and efficacy of different types of anticoagulants would help clinicians to prevent thromboembolic events among patients with atrial fibrillation (AF) while minimising the risk of haemorrhages.

aimTo estimate the risk of thromboembolic and haemorrhagic events for patients with AF on antiplatelets or anticoagulants. DESIGN AND

settingThis was a cohort study using routinely collected UK primary and secondary care clinical data from patients with AF, aged ≥18 years, and with an indication to receive anticoagulation before April 2012.

methodThe risk of ischaemic stroke or transient ischaemic attack (TIA), coronary heart disease (CHD), peripheral artery disease (PAD), or gastrointestinal (GI) haemorrhage, between 1 April 2012 and 1 April 2017, was estimated using multivariate Cox regression models for patients on antiplatelets only, a combination of antiplatelets and vitamin K antagonists (VKAs), or novel oral anticoagulants (NOACs), and compared with those on VKAs only.

resultsCompared with VKAs, antiplatelets were associated with a higher risk of stroke or TIA, hazard ratio (HR) 1.51, 95% confidence interval (CI) = 1.09 to 2.09, and GI haemorrhage, HR 1.79, 95% CI = 1.01 to 3.18. The risk of thromboembolic and haemorrhagic events was similar for those on a combination of antiplatelets and VKAs, or those on VKAs only. The risk was also similar for those on NOACs or VKAs, except for CHD, where it was higher for patients on NOACs, HR 2.07, 95% CI = 1.35 to 3.19.

conclusionAnticoagulants are associated with lower risk of thromboembolic and haemorrhagic events among patients with AF than antiplatelets. More research is required on the risk associated with VKAs or NOACs.

Indexed as

AgedAged, 80 and overAnticoagulantsAtrial FibrillationBrain IschemiaCohort StudiesFemaleGastrointestinal HemorrhageHumansMaleMiddle AgedPlatelet Aggregation InhibitorsPrimary Health CareProportional Hazards ModelsSecondary Health CareStrokeAnticoagulantsPlatelet Aggregation Inhibitorsanticoagulantsatrial fibrillationgastrointestinal haemorrhagemyocardial ischaemiaprimary health carestroke

Identifiers

PMID31015222
PMCPMC6532794
OpenAlexW2941988749

What OpenQuestion holds

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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.