Evidence map›Paper›PMID 33593994›Full record

ArticleHeart (British Cardiac Society)2021

Comparative effectiveness of oral anticoagulants in everyday practice.

A John Camm, Keith A A Fox, Saverio Virdone, Jean-Pierre Bassand, David A Fitzmaurice, Samuel I Berchuck, Bernard J Gersh, Samuel Z Goldhaber, Shinya Goto, Sylvia Haas and 7 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart (British Cardiac Society), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01090362 (Prospective, Multi Centre, International Registry of Male and Female Patients Newly Diagnosed With Atrial Fibrillation.), which is not on this map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
2.8field-weighted citation impact, top 8% 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.

NCT01090362 completednot on this map

Prospective, Multi Centre, International Registry of Male and Female Patients Newly Diagnosed With Atrial Fibrillation.

TypeobservationalSponsorThrombosis Research InstituteRan2009 to 2020Enrolled57,250ConditionsAtrial Fibrillation
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 21 citations in OpenAlex.

  1. Article
  2. Observational
  3. Observational
  4. Article
  5. Article
  6. The influence of atrial high-rate episodes on stroke and cardiovascular death: an update.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  7. Article
  8. Review
  9. Review
  10. Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2022
    Article
  11. Article
  12. Two-year outcomes of UK patients newly diagnosed with atrial fibrillation: findings from the prospective observational cohort study GARFIELD-AF.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022
    Article
  13. Article
  14. Article
  15. Article
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

17 authors at 14 institutions in 8 countries.

A John CammCardiology Clinical Academic Group Molecular & Clinical Sciences Research Institute, St. George's University of London, London, UK jcamm@sgul.ac.uk.ORCID http://orcid.org/0000-0002-2536-2871
Keith A A FoxCentre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
Saverio VirdoneThrombosis Research Institute, London, UK.
Jean-Pierre BassandThrombosis Research Institute, London, UK.
David A FitzmauriceWarwick Medical School, University of Warwick, Coventry, UK.
Samuel I BerchuckDuke University, Durham, North Carolina, USA.
Bernard J GershDepartment of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Samuel Z GoldhaberDepartment of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Shinya GotoDepartment of Medicine (Cardiology), Tokai University School of Medicine, Kanagawa, Japan.
Sylvia HaasDepartment of Medicine, Formerly Technical University of Munich, Munich, Germany.
Frank MisselwitzBayer AG, Berlin, Germany.
Karen S PieperThrombosis Research Institute, London, UK.
Alexander G G TurpieDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Freek W A VerheugtDepartment of Cardiology, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-5831-6951
Riccardo CappatoArrhythmia & Electrophysiology Center, IRCCS - MultiMedica Group, Sesto San Giovanni (Milan), Italy.
Ajay K KakkarThrombosis Research Institute, London, UK.
GARFIELD-AF investigators
Thrombosis Research Institute · GBBayer (Germany) · DEBrigham and Women's Hospital · USCentre Hospitalier Universitaire de Besançon · FRDuke University · USMayo Clinic · USMcMaster University · CAMultiMedica · ITOLVG · NLSt George's, University of London · GBTechnical University of Munich · DETokai University · JPUniversity of Edinburgh · GBUniversity of Warwick · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study evaluated the comparative effectiveness of vitamin K antagonists (VKAs), direct thrombin inhibitors (DTIs) and factor Xa inhibitors (FXaI) in patients with atrial fibrillation (AF) at risk of stroke in everyday practice.

methodsData from patients with AF and Congestive heart failure, Hypertension, Age 75 years, Diabetes mellitus, prior Stroke, TIA, or thromboembolism, Vascular disease, Age 65-74 years, Sex category (CHA

resultsAll-cause mortality, non-haemorrhagic stroke/systemic embolism (SE) and major bleeding over 2 years were compared in 25 551 patients, 7162 (28.0%) not treated with oral anticoagulant (OAC) and 18 389 (72.0%) treated with OAC (FXaI (41.8%), DTI (11.4%) and VKA (46.8%)). OAC treatment compared with no OAC treatment was associated with decreased risk of all-cause mortality (HR 0.82 (95% CI 0.74 to 0.91)) and non-haemorrhagic stroke/SE (HR 0.71 (95% CI 0.57 to 0.88)) but increased risk of major bleeding (HR 1.46 (95% CI 1.15 to 1.86)). Non-vitamin K antagonist oral anticoagulant (NOAC) use compared with no OAC treatment was associated with lower risks of all-cause mortality and non-haemorrhagic stroke/SE (HR 0.67 (95% CI 0.59 to 0.77)) and 0.65 (95% CI 0.50 to 0.86)) respectively, with no increase in major bleeding (HR 1.10 (95% CI 0.82 to 1.47)). NOAC use compared with VKA use was associated with lower risk of all-cause mortality and major bleeding (rates/100 patient-years 3.6 (95% CI 3.3 to 3.9) vs 4.8 (95% CI 4.5 to 5.2) and 1.0 (95% CI 0.9 to 1.1) vs 1.4 (95% CI 1.2 to 1.6); HR 0.79 (95% CI 0.70 to 0.89) and 0.77 (95% CI 0.61 to 0.98) respectively), with similar risk of non-haemorrhagic stroke/SE (rates/100 patient-years 0.8 (95% CI 0.7 to 0.9) versus 1.0 (95% CI 0.8 to 1.1); HR 0.96 (95% CI 0.73 to 1.25).

conclusionImportant benefits in terms of mortality and major bleeding were observed with NOAC versus VKA with no difference among NOAC subtypes. TRIAL REGISTRATION NUMBER: NCT01090362.

Indexed as

anticoagulationatrial fibrillationnon-vitamin K oral antagoniststrokevitamin K antagonist

Identifiers

PMID33593994
PMCPMC8165153
OpenAlexW3130408264

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

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.