ArticleCirculation. Cardiovascular quality and outcomes2019
Net Clinical Benefit of Oral Anticoagulation Among Older Adults With Atrial Fibrillation.
Article in Circulation. Cardiovascular quality and outcomes, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Effectiveness and Safety of Oral Anticoagulants in Older Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2020Pooled it
- Benefit-Risk Assessment of Rivaroxaban in Older Patients With Nonvalvular Atrial Fibrillation or Venous Thromboembolism.Drugs & aging · 2025Trial
- Modelling anticoagulation and health-related quality of life in those with atrial fibrillation: a secondary analysis of AFFIRM.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Trial
- Anticoagulation Outcomes in Nursing Home Residents With Atrial Fibrillation and ADL Disability.JAMA network open · 2026Article
- Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced CKD Not Requiring Dialysis.JAMA network open · 2026Article
- Direct oral anticoagulants in elderly patients with atrial fibrillation: a decade-long nationwide retrospective cohort study.BMJ open · 2026Article
- Practical Recommendations for Anticoagulation in Patients With Atrial Fibrillation.European journal of clinical investigation · 2026Review
- An Overview of Anticoagulant Drugs Pharmacology, Therapeutic Approaches, Limitations and Perspectives.Pharmaceutics · 2026Review
- Anticoagulation in Frail Older Adults with Non-Valvular Atrial Fibrillation: Clinical Challenges and Personalized Approach.Journal of clinical medicine · 2025Review
- Stroke prophylaxis after US emergency department diagnosis and discharge of patients with atrial fibrillation and flutter from 21 hospitals.International journal of emergency medicine · 2025Article
- Anticoagulation at the end of life: whether, when, and how to treat.Hematology. American Society of Hematology. Education Program · 2024Review
- Novel horizons in anticoagulation: the emerging role of factor XI inhibitors across different settings.Haematologica · 2024Review
- Factors influencing deprescribing in primary care for those towards the end of life: A qualitative interview study with patients and healthcare practitioners.Palliative medicine · 2024Article
- To treat or not to treat: a comparative effectiveness analysis of oral anticoagulant outcomes among U.S. nursing home residents with atrial fibrillation.BMC geriatrics · 2024Article
- Estimating Vitamin K Antagonist Anticoagulation Benefit in People With Atrial Fibrillation Accounting for Competing Risks: Evidence From 12 Randomized Trials.Circulation. Cardiovascular quality and outcomes · 2024Article
- Combination of early rhythm control and healthy lifestyle on the risk of stroke in elderly patients with new-onset atrial fibrillation: a nationwide population-based cohort study.Frontiers in cardiovascular medicine · 2024Article
- Predictive value of bleeding risk scores in elderly patients with atrial fibrillation and oral anticoagulation.Journal of geriatric cardiology : JGC · 2023Article
- Comparative Effectiveness and Safety of Oral Anticoagulants by Dementia Status in Older Patients With Atrial Fibrillation.JAMA network open · 2023Article
- The Aging Heart: A Molecular and Clinical Challenge.International journal of molecular sciences · 2022Review
- Antithrombotic treatment switching in elderly patients with atrial fibrillation and the risk of thromboembolism, bleeding, and cardiac death.Research and practice in thrombosis and haemostasis · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundWhile guidelines recommend anticoagulation for all atrial fibrillation (AF) patients ≥75 years, evidence for the net clinical benefit (NCB) of anticoagulant in older adults is sparse. We sought to determine the association between age and NCB of anticoagulation in older adults with AF. METHODS AND
resultsWe examined adults ≥75 years with incident AF in the Anticoagulation and Risk Factors in Atrial Fibrillation-Cardiovascular Research Network cohort. Using a Markov state transition model, we estimated the lifetime NCB of warfarin and apixaban relative to no treatment in quality-adjusted life years (QALYs). In the decision model, each month patients face a chance of stroke, hemorrhage, or death from a competing cause; the likelihood of each is a function of individual patients' stroke risk, hemorrhage risk, and life expectancy. We defined minimal clinically relevant lifetime benefit as 0.10 QALYs. In a sensitivity analysis, we examined the effect of competing risks of death on NCB using 2 models, one including competing risks and the second without competing risks. We included 14 946 patients, with a median age of 81 years and median CHA
conclusionsThe NCB of anticoagulation decreases with advancing age. The competing risk of death diminishes the NCB of anticoagulation for older patients with AF. Physicians should consider competing mortality risks when recommending anticoagulants to older adults with AF.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.