Evidence map›Paper›PMID 31942972›Full record

Observational studyEuropean heart journal. Cardiovascular pharmacotherapy2020

Comparison of dabigatran, rivaroxaban, and apixaban for effectiveness and safety in atrial fibrillation: a nationwide cohort study.

Ole-Christian W Rutherford, Christian Jonasson, Waleed Ghanima, Fabian Söderdahl, Sigrun Halvorsen

Open access · hybridAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European heart journal. Cardiovascular pharmacotherapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 3 pooled it
9.3field-weighted citation impact, top 1% 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

46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.

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  19. Comparison of vitamin K and non-vitamin K oral anticoagulants and the bleeding frequency in the emergency department.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2024
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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 4 institutions in 2 countries.

Ole-Christian W RutherfordDepartment of Cardiology, Østfold Hospital Trust, PO Box 300, 1714 Grålum, Sarpsborg, Norway.
Christian JonassonHUNT Research Centre, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway.
Waleed GhanimaInstitute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway.
Fabian SöderdahlStatisticon AB, Klara Södra kyrkogata 1, 111 52 Stockholm, Sweden.
Sigrun HalvorsenInstitute of Clinical Medicine, University of Oslo, PO Box 1171 Blindern, 0318 Oslo, Norway.
University of Oslo · NONorwegian University of Science and Technology · NOOslo University Hospital · NOStatisticon (Sweden) · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe aim of this study was to compare the risk of stroke or systemic embolism (SE) and major bleeding in patients with atrial fibrillation (AF) using dabigatran, rivaroxaban, and apixaban in routine clinical practice. METHODS AND

resultsUsing nationwide registries in Norway from January 2013 to December 2017, we established a cohort of 52 476 new users of non-vitamin K antagonist oral anticoagulants (NOACs) with AF. Users of individual NOACs were matched 1:1 on the propensity score to create three pairwise-matched cohorts: dabigatran vs. rivaroxaban (20 504 patients), dabigatran vs. apixaban (20 826 patients), and rivaroxaban vs. apixaban (27 398 patients). Hazard ratios (HRs) for the risk of stroke or SE and major bleeding were estimated. In the propensity-matched comparisons of the risk of stroke or SE, the HRs were 0.88 [95% confidence interval (CI) 0.76-1.02] for dabigatran vs. rivaroxaban, 0.88 (95% CI 0.75-1.02) for dabigatran vs. apixaban, and 1.00 (95% CI 0.89-1.14) for apixaban vs. rivaroxaban. For the risk of major bleeding, the HRs were 0.75 (95% CI 0.64-0.88) for dabigatran vs. rivaroxaban, 1.03 (95% CI 0.85-1.24) for dabigatran vs. apixaban, and 0.79 (95% CI 0.68-0.91) for apixaban vs. rivaroxaban.

conclusionIn this nationwide study of patients with AF in Norway, we found no statistically significant differences in risk of stroke or SE in propensity-matched comparisons between dabigatran, rivaroxaban, and apixaban. However, dabigatran and apixaban were both associated with significantly lower risk of major bleeding compared with rivaroxaban.

Indexed as

AgedAged, 80 and overAntithrombinsAtrial FibrillationDabigatranDatabases, FactualEmbolismFactor Xa InhibitorsFemaleHemorrhageHumansIncidenceMaleMiddle AgedNorwayPatient SafetyAntithrombinsapixabanDabigatranFactor Xa InhibitorsPyrazolesPyridonesRivaroxabanAtrial fibrillationBleedingNon-vitamin K antagonist anticoagulantsStroke

Identifiers

PMID31942972
PMCPMC7073510
OpenAlexW2998942685

What OpenQuestion holds

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LicenceCC BY
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.