Evidence map›Paper›PMID 33219708›Full record

SynthesisClinical cardiology2021

Benefit and risk of adding rivaroxaban in patients with coronary artery disease: A systematic review and meta-analysis.

Cheng Xie, Yongfu Hang, Jianguo Zhu, Caiyun Li, Bin Jiang, Yuzhen Zhang, Liyan Miao

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 28% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Review
  4. Article
  5. 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

7 authors at 2 institutions in 1 country.

Cheng XieDepartment of Clinical Pharmacology, the First Affiliated Hospital of Soochow University, Suzhou, China.ORCID https://orcid.org/0000-0002-6681-3405
Yongfu HangDepartment of Clinical Pharmacology, the First Affiliated Hospital of Soochow University, Suzhou, China.
Jianguo ZhuDepartment of Clinical Pharmacology, the First Affiliated Hospital of Soochow University, Suzhou, China.
Caiyun LiDepartment of Pharmacy, the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, China.
Bin JiangDepartment of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, China.
Yuzhen ZhangDepartment of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou, China.
Liyan MiaoDepartment of Clinical Pharmacology, the First Affiliated Hospital of Soochow University, Suzhou, China.
Soochow University · CNSuzhou University of Science and Technology · CN

Funding

National Natural Science Foundation of China 81503140National Natural Science Foundation of China 81700298National Natural Science Foundation of China 81803628
6 · The paper itself

Abstract

backgroundAlthough the European Medicines Agency and the US Food and Drug Administration have, respectively, approved rivaroxaban for the prevention of recurrent major adverse cardiovascular events in patients with myocardial infarction and stable coronary artery disease, its efficacy and safety is unclear. This meta-analysis aimed to evaluate the benefit and risk of adding rivaroxaban in coronary artery disease (CAD) patients, focusing on treatment effects stratified by different baseline clinical presentations. HYPOTHESIS: There are differences in treatment effects of adding rivaroxaban among CAD patients with different baseline clinical presentations.

methodsMedline, EMBASE, and Cochrane Databases were systematically searched from inception to 21 July 2020 for randomized controlled trials (RCTs) comparing rivaroxaban in CAD patients. The primary efficacy endpoint and safety endpoint were assessed by using Mantel-Haenszel pooled risk ratios (RRs) and 95% confidence intervals (CIs).

resultsFive RCTs that included 43 650 patients were identified. Patients receiving rivaroxaban had a significantly lower risk of the primary efficacy endpoint (RR, 0.86; 95% CI, 0.76-0.97, p = .01) accompanied by increased risk of the primary safety endpoint (RR, 1.83; 95% CI, 1.10-3.05, p = .02). Subgroup analyses showed that in males the risk-benefit appears to be more favorable while in patients ≥65 years, in females, in patients with diabetes, those with mild to moderate impaired renal function, and region of Asia/other seems unfavorable.

conclusionRivaroxaban may provide an additional choice for secondary prevention in CAD patients. However, careful estimation of the risk of ischemic and bleeding events using patient characteristics are critical to achieving net benefit.

Indexed as

Coronary Artery DiseaseFactor Xa InhibitorsHemorrhageHumansRisk FactorsRivaroxabanFactor Xa InhibitorsRivaroxabancoronary artery diseasemeta-analysisrivaroxaban

Identifiers

PMID33219708
PMCPMC7803358
OpenAlexW3100849006

What OpenQuestion holds

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LicenceCC BY
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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.