SynthesisAge and ageing2021
Reasons for discontinuing oral anticoagulation therapy for atrial fibrillation: a systematic review.
Synthesis in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Oral anticoagulants: a systematic overview of reviews on efficacy and safety, genotyping, self-monitoring, and stakeholder experiences.Systematic reviews · 2022Pooled it
- Epistaxis Versus Nonepistaxis Bleeding in Anticoagulated Patients With Atrial Fibrillation: Results From the ENGAGE AF-TIMI 48 Trial.Journal of the American Heart Association · 2025Trial
- Observational
- Anticoagulation Outcomes in Nursing Home Residents With Atrial Fibrillation and ADL Disability.JAMA network open · 2026Article
- Left Atrial Appendage Closure in Patients Refusing Oral Anticoagulation: The LAAC-REFUSAL Study.Journal of the American Heart Association · 2025Article
- Safety and effectiveness of anticoagulation therapy in older people with atrial fibrillation during exposed and unexposed treatment periods.Heart (British Cardiac Society) · 2025Article
- Non-adherence and non-persistence of Direct Oral Anticoagulants among patients with non-valvular atrial fibrillation: a French retrospective cohort study.Scientific reports · 2025Article
- Co-occurrence of Frailty, Possible Sarcopenia, and Malnutrition in Community-Dwelling Older Outpatients: A Multicentre Observational Study.Annals of geriatric medicine and research · 2025Observational
- A review of the use of oral anticoagulants in individuals with atrial fibrillation who had experienced intracranial hemorrhage in the past.International journal of physiology, pathophysiology and pharmacology · 2025Review
- The influence of epicardial adipose tissue on the prognosis of atrial fibrillation patients undergoing radiofrequency ablation combined with left atrial appendage occlusion.Scientific reports · 2024Article
- Article
- Article
- Discontinuation of Oral Anticoagulants in Atrial Fibrillation Patients: Impact of Treatment Strategy and on Patients' Health Status.Journal of clinical medicine · 2023Article
- Heterogeneous distributions in clinical events preceding anticoagulant treatment nonpersistence in patients with venous thromboembolism stratified by active cancer: A nationwide cohort study.Cancer medicine · 2023Article
- Implications of Clinical Risk Phenotypes on the Management and Natural History of Atrial Fibrillation: A Report From the GLORIA-AF.Journal of the American Heart Association · 2023Article
- Discontinuation of oral anticoagulant use among nursing home residents with atrial fibrillation before hospice enrollment.Journal of the American Geriatrics Society · 2023Article
- Safety and Healthcare Resource Utilization in Patients Undergoing Left Atrial Appendage Closure-A Nationwide Analysis.Journal of clinical medicine · 2023Article
- Ischemic Stroke and Systemic Embolism Among One-and-Done Direct Oral Anticoagulant Users with Non-valvular Atrial Fibrillation.Advances in therapy · 2023Article
- Oral Anticoagulant Discontinuation and Its Predictors in Patients with Atrial Fibrillation.Journal of clinical medicine · 2022Article
- Frailty and cerebrovascular disease: Concepts and clinical implications for stroke medicine.International journal of stroke : official journal of the International Stroke Society · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAtrial fibrillation (AF) is the most common cardiac arrhythmia and can lead to significant comorbidities and mortality. Persistence with oral anticoagulation (OAC) is crucial to prevent stroke but rates of discontinuation are high. This systematic review explored underlying reasons for OAC discontinuation.
methodsA systematic review was undertaken to identify studies that reported factors influencing discontinuation of OAC in AF, in 11 databases, grey literature and backwards citations from eligible studies published between 2000 and 2019. Two reviewers independently screened titles, abstracts and papers against inclusion criteria and extracted data. Study quality was appraised using Gough's weight of evidence framework. Data were synthesised narratively.
resultsOf 6,619 sources identified, 10 full studies and 2 abstracts met the inclusion criteria. Overall, these provided moderate appropriateness to answer the review question. Four reported clinical registry data, six were retrospective reviews of patients' medical records and two studies reported interviews and surveys. Nine studies evaluated outcomes relating to dabigatran and/or warfarin and three included rivaroxaban (n = 3), apixaban (n = 3) and edoxaban (n = 1). Bleeding complications and gastrointestinal events were the most common factors associated with discontinuation, followed by frailty and risk of falling. Patients' perspectives were seldom specifically assessed. Influence of family carers in decisions regarding OAC discontinuation was not examined.
conclusionThe available evidence is derived from heterogeneous studies with few relevant data for the newer direct oral anticoagulants. Reasons underpinning decision-making to discontinue OAC from the perspective of patients, family carers and clinicians is poorly understood.
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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.