Evidence map›Paper›PMID 33831130›Full record

ArticlePloS one2021

Effectiveness and safety of rivaroxaban versus warfarin in Taiwanese patients with end-stage renal disease and nonvalvular atrial fibrillation: A real-world nationwide cohort study.

Yi-Cheng Lin, Bi-Li Chen, Chun-Ming Shih, Feng-Yen Lin, Chih-Wei Chen, Chien-Yi Hsu, Yung-Ta Kao, Wei-Fung Bi, Li-Ying Chen, Li-Nien Chien and 2 more

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 11 pooled it
3.9field-weighted citation impact, top 5% 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

20 citing papers in PubMed, 11 syntheses or guidelines pooled it, 34 citations in OpenAlex.

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  11. Factor Xa Inhibitors Versus Vitamin K Antagonists in Atrial Fibrillation Patients with End-Stage Kidney Disease on Dialysis: A Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
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  15. 2025 Thai guideline for the diagnosis and management of atrial fibrillation.Asian biomedicine : research, reviews and news · 2025
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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

12 authors at 2 institutions in 1 country.

Yi-Cheng LinDepartment of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan.ORCID 0000-0002-3599-7758
Bi-Li ChenDepartment of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan.
Chun-Ming ShihDivision of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Feng-Yen LinDivision of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Chih-Wei ChenDivision of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Chien-Yi HsuDivision of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Yung-Ta KaoDivision of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Wei-Fung BiDivision of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Li-Ying ChenHealth and Clinical Research Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan.
Li-Nien ChienSchool of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.
Te-Chao FangDivision of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.ORCID 0000-0002-5577-9280
Chun-Yao HuangDivision of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.ORCID 0000-0002-8978-7879
Taipei Medical University Hospital · TWTaipei Medical University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal anticoagulant for end-stage renal disease patients for stroke prophylaxis is unknown. The efficacy and safety of warfarin in this population are debatable. In addition, real-world evidence of direct oral anticoagulants in patients with end-stage renal disease is limited. The aim of this study was to evaluate the clinical outcomes of rivaroxaban compared with warfarin in Taiwanese patients with end-stage renal disease with nonvalvular atrial fibrillation in a real-world setting. METHODS AND

resultsThis was a retrospective population-based cohort study conducted using Taiwan's National Health Insurance Research Database. Patients with nonvalvular atrial fibrillation and end-stage renal disease who started on rivaroxaban or warfarin between February 2013 and September 2017 were eligible to participate in the study. The inverse probability of treatment weighting approach was used to balance baseline characteristics. Bleeding and thromboembolic outcomes were compared using competing risk analyses. The study population consisted of 3358 patients (173 and 3185 patients on rivaroxaban and warfarin, respectively). In the rivaroxaban group, 50.8%, 38.7%, and 10.4% of the patients received 10, 15, and 20 mg of the drug, respectively. The cumulative incidence of major bleeding was similar between the two groups; however, the gastrointestinal bleeding rate was lower in the rivaroxaban group (adjusted subdistribution hazard ratio [SHR]: 0.56, 95% confidence interval [CI]: 0.34-0.91) than in the warfarin group. Furthermore, the composite risk of ischemic stroke or systemic embolism was significantly lower in the rivaroxaban group (adjusted SHR: 0.36, 95% CI: 0.17-0.79). Similar findings were observed for patients who received 10 mg of rivaroxaban.

conclusionsIn Taiwanese patients with end-stage renal disease and nonvalvular atrial fibrillation, rivaroxaban may be associated with a similar risk of major bleeding but a lower risk of thromboembolism compared with warfarin. The potential benefit of 10 mg of rivaroxaban in this population requires further investigation.

Indexed as

AdultAgedAged, 80 and overAtrial FibrillationFemaleGastrointestinal HemorrhageHumansIncidenceKidney Failure, ChronicMaleMiddle AgedRetrospective StudiesRivaroxabanTaiwanThromboembolismWarfarinRivaroxabanWarfarin

Identifiers

PMID33831130
PMCPMC8031437
OpenAlexW3151379724

What OpenQuestion holds

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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.