Evidence map›Paper›PMID 32880804›Full record

SynthesisCardiovascular drugs and therapy2021

Efficacy and Safety of Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Liver Disease: a Meta-Analysis and Systematic Review.

Zhi-Chun Huang, Chang-Qing Li, Xiao-Yu Liu, Zhong-Chao Cao, Hai-Yu Jia, Ying Dong, Tian-Long Liu, Jian-Jun Sun

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Cardiovascular drugs and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.5field-weighted citation impact, top 9% 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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
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 1 institution in 1 country.

Zhi-Chun HuangDepartment of Cardiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Chang-Qing LiDepartment of Cardiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Xiao-Yu LiuDepartment of Cardiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Zhong-Chao CaoDepartment of Cardiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Hai-Yu JiaDepartment of Cardiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Ying DongDepartment of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, 1 Tong Dao North Street, Hohhot, Inner Mongolia, 010059, People's Republic of China.
Tian-Long LiuDepartment of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, 1 Tong Dao North Street, Hohhot, Inner Mongolia, 010059, People's Republic of China.
Jian-Jun SunDepartment of Pharmacy, Affiliated Hospital of Inner Mongolia Medical University, 1 Tong Dao North Street, Hohhot, Inner Mongolia, 010059, People's Republic of China. sunjianjun8840@bjmu.edu.cn.ORCID 0000-0002-4921-4857
Inner Mongolia Medical University · CN

Funding

Natural Science Foundation of China 81960770Natural Science Foundation of Inner Mongolia 2018MS08099Project of Inner Mongolia Science & Technology Program 201802112
6 · The paper itself

Abstract

backgroundLiver disease is associated with increased bleeding risk. The efficacy and safety of direct oral anticoagulants (DOACs) is a subject of contention in atrial fibrillation (AF) patients with liver disease.

methodsElectronic databases (PubMed, Embase, and Cochrane Library) were searched to retrieve studies on the efficacy and safety of DOACs versus warfarin in AF patients with liver disease from January 1980 to April 2020. A meta-analysis was conducted using a random-effects model.

resultsSix studies involving 41,859 patients were included. Compared with warfarin, DOACs demonstrated significant reduction in ischemic stroke (HR, 0.68; 95% CI (0.54-0.86)), major bleeding (0.74 (0.59-0.92)), and intracranial hemorrhage (ICH) (0.48 (0.40-0.58)), with no significant effect on gastrointestinal bleeding (P = 0.893) in AF patients with liver disease. Similar results were observed in regular-dose, reduced-dose, and active liver disease subgroups, albeit Asian patients had a slight reduction in major bleeding (P = 0.055). Furthermore, the pooled estimates of individual DOAC subgroups indicated that dabigatran and apixaban led to greater safety in major bleeding (P < 0.001), ICH (P < 0.001), and gastrointestinal bleeding (P < 0.005) in these patients. The same trends were observed in AF patients with cirrhosis.

conclusionsOur findings suggest that DOACs significantly reduce the risk of ischemic stroke, major bleeding, and ICH, with no significant effect on the risk of gastrointestinal bleeding in AF patients with liver disease compared with warfarin.

Indexed as

AntithrombinsAtrial FibrillationDabigatranDose-Response Relationship, DrugFactor Xa InhibitorsHemorrhageHumansLiver DiseasesPyrazolesPyridonesStrokeAntithrombinsapixabanDabigatranFactor Xa InhibitorsPyrazolesPyridonesAnticoagulantsAtrial fibrillationLiver cirrhosisLiver failureMeta-analysis

Identifiers

PMID32880804
OpenAlexW3083006067

What OpenQuestion holds

Textmetadata
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.