Evidence map›Paper›PMID 33334444›Full record

ArticleJACC. Clinical electrophysiology2020

Clinical Outcomes of Warfarin Initiation in Advanced Chronic Kidney Disease Patients With Incident Atrial Fibrillation.

Manyoo A Agarwal, Praveen K Potukuchi, Keiichi Sumida, Adnan Naseer, Miklos Z Molnar, Lekha K George, Santhosh K Koshy, Elani Streja, Fridtjof Thomas, Kamyar Kalantar-Zadeh and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Clinical electrophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 17% 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

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Manyoo A AgarwalDepartment of Internal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Department of Internal Medicine, Division of Cardiovascular Medicine, University of California Los Angeles, Los Angeles, California, USA.
Praveen K PotukuchiDivision of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Keiichi SumidaDivision of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Nephrology Section, Memphis VA Medical Center, Memphis, Tennessee, USA.
Adnan NaseerMethodist University Hospital James D. Eason Transplant Institute, Memphis, Tennessee.
Miklos Z MolnarDivision of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Methodist University Hospital James D. Eason Transplant Institute, Memphis, Tennessee; Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Lekha K GeorgeNephrology Section, Memphis VA Medical Center, Memphis, Tennessee, USA.
Santhosh K KoshyDivision of Cardiovascular Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Elani StrejaHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California-Irvine, Orange, California, USA.
Fridtjof ThomasDivision of Biostatistics, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Kamyar Kalantar-ZadehHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California-Irvine, Orange, California, USA.
Csaba P KovesdyDivision of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Nephrology Section, Memphis VA Medical Center, Memphis, Tennessee, USA. Electronic address: ckovesdy@uthsc.edu.
University of Tennessee Health Science Center · USUniversity of California, Irvine · USMemphis VA Medical Center · USMethodist University Hospital · US

Funding

Transition of Care in CKD (TC-CKD)U01DK102163 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI JACOBSEN, STEVEN J, KALANTAR-ZADEH, KAMYAR · 2014 to 2018
$2.8M
Improving Analysis of Endogenous Multimodal Treatments for Use in Geriatrics Health Outcomes StudiesI01HX002237 · VA · VA BOSTON HEALTH CARE SYSTEM · PI GARRIDO, MELISSA M · 2018 to 2021
–
HSRD VA SDR 02-237NIDDK NIH HHS U01 DK102163
6 · The paper itself

Abstract

objectivesThe aim of this study was to examine the efficacy and safety of warfarin initiation following the diagnosis of atrial fibrillation (AF) in patients with late-stage chronic kidney disease (CKD) who transitioned to dialysis.

backgroundThe clinical benefit of warfarin therapy for thromboprophylaxis after incident AF diagnosis in patients with late-stage CKD who are transitioning to dialysis is unknown.

methodsIn this retrospective cohort analysis, the study population was a national cohort of 22,771 U.S. veterans with incident end-stage renal disease who developed incident AF before initiating renal replacement therapy. This study examined the association of warfarin therapy following the diagnosis of incident AF with ischemic cerebrovascular accidents (CVAs) (ischemic stroke or transient ischemic attack), ischemic CVA-related hospitalization, major bleeding events (gastrointestinal or intracranial bleeding), bleeding event-related hospitalizations, and post-dialysis, all-cause mortality in multivariable adjusted Cox regression analyses that adjusted for demographic characteristics and comorbidities.

resultsThe mean ± SD age of the cohort was 73.5 ± 8.8 years, 13% were African American, and the mean CHA

conclusionsIn patients with late-stage CKD who transitioned to dialysis, warfarin use was associated with higher risk of ischemic and bleeding events but a lower risk of mortality. Future studies such as those comparing warfarin with newer oral anticoagulant agents are needed to granularly define the net clinical benefit of anticoagulation therapy in patients with advanced CKD with incident AF.

Indexed as

Atrial FibrillationRenal Insufficiency, ChronicVenous ThromboembolismAgedAged, 80 and overAnticoagulantsHumansMiddle AgedRetrospective StudiesWarfarinAnticoagulantsWarfarinatrial fibrillationbleedingchronic kidney diseasestrokewarfarin

Identifiers

PMID33334444
PMCPMC7872315
OpenAlexW3084659488

What OpenQuestion holds

Textmetadata
LicenceTDM
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.