Evidence map›Paper›PMID 32677373›Full record

ArticleESC heart failure2020

Novel oral anticoagulant vs. warfarin in elderly atrial fibrillation patients with normal, mid-range, and reduced left ventricular ejection fraction.

Victor Chien-Chia Wu, Chun-Li Wang, Cheng-Hung Lee, Yu-Ling Chen, Hui-Tzu Tu, Michael Wu, Chang-Fu Kuo, Shao-Wei Chen, Yu-Tung Huang, Ming-Shien Wen and 1 more

Open access · goldAbstract read
In one paragraph

Article in ESC heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 39% 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

4 citing papers in PubMed, 3 citations in OpenAlex.

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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

11 authors at 6 institutions in 3 countries.

Victor Chien-Chia WuDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan City, 33305, Taiwan.
Chun-Li WangDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan City, 33305, Taiwan.
Cheng-Hung LeeDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan City, 33305, Taiwan.
Yu-Ling ChenCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Hui-Tzu TuCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Michael WuDivision of Cardiovascular Medicine, Arrhythmia Services Section, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
Chang-Fu KuoCollege of Medicine, Chang Gung University, Taoyuan City, Taiwan.
Shao-Wei ChenCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Yu-Tung HuangCenter for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan.
Ming-Shien WenDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan City, 33305, Taiwan.
Shang-Hung ChangDivision of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan City, 33305, Taiwan.
Linkou Chang Gung Memorial Hospital · TWChang Gung Memorial Hospital · TWChang Gung University · TWBrown University · USChang Gung University of Science and Technology · TWUniversity of Nottingham · GB

Funding

Center for Big Data Analytics and Statistics CLRPG3D0045Center for Big Data Analytics and Statistics CORPG3G0271Center for Big Data Analytics and Statistics CORPG3J0031
6 · The paper itself

Abstract

aimsPatients with concomitant atrial fibrillation (AF) and reduced left ventricular ejection fraction (LVEF) have poor prognosis. Outcomes of novel oral anticoagulant (NOAC) in elderly AF patients with normal, mid-range, and reduced LVEF were investigated. METHODS AND

resultsData were retrieved from Chang Gung Research Database during 2010-2017 for patients with AF. We excluded patients with venous thromboembolism within 6 months, total knee/hip replacement and heart valve replacement within 6 months, end-stage renal disease, stroke/systemic embolism (SE)/death within 7 days, age <65 years old, or no records of LVEF. Primary outcomes were ischaemic stroke (IS)/SE, major bleeding, and death from any cause. There was a total of 50 035 elderly AF patients retrieved. After exclusion criteria, 9615 patients with normal LVEF ≥ 50%, 737 with mid-range LVEF 41-49%, and 908 with reduced LVEF ≤ 40% were studied. At end of follow-up, patients on NOAC had significantly reduced IS/SE compared with warfarin in LVEF ≥ 50% [adjusted hazard ration (aHR) 0.80, 95% confidence interval (CI) 0.71-0.89] and LVEF 41-49% (aHR 0.57, 95% CI 0.36-0.88) after adjusting for covariates, while there was no difference in LVEF ≤ 40%. Patients on NOAC had significantly reduced major bleeding in all LVEF groups. In addition, patients on NOAC had significantly reduced death compared with warfarin in LVEF ≥ 50% (aHR 0.81, 95% CI 0.67-0.98).

conclusionsIn elderly AF patients ≥65 years, using NOAC was associated with lower IS/SE compared with warfarin in normal and mid-range LVEF but not in reduced LVEF. Using NOACs was associated with lower death compared with warfarin in normal LVEF.

Indexed as

Atrial FibrillationBrain IschemiaStrokeAdministration, OralAgedAnticoagulantsHumansStroke VolumeVentricular Function, LeftWarfarinAnticoagulantsWarfarinAnticoagulationAtrial fibrillationLeft ventricular ejection fraction

Identifiers

PMID32677373
PMCPMC7524083
OpenAlexW3042936723

What OpenQuestion holds

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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.