ReviewIndian heart journal
Long-term oral anticoagulation for atrial fibrillation in low and middle income countries.
Review in Indian heart journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Anticoagulation quality through time in therapeutic range in Sub-Saharan Africa: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Rivaroxaban versus vitamin K antagonist treatment on the progression of coronary calcification: the IRIVASC-trial.Scientific reports · 2024Trial
- Oral anticoagulant prescribing and DOAC dosing appropriateness in patients with non-valvular atrial fibrillation: a retrospective study from Vietnam.BMC cardiovascular disorders · 2026Observational
- Implementing David Procedure in Latin America: Closing the Gap with High-Income Countries.Brazilian journal of cardiovascular surgery · 2026Article
- Clinical complexity in patients with atrial fibrillation: exploring differential risk profiles from European and Asian cohorts.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 · 2025Article
- Quality of Oral Anticoagulation Control with Warfarin According to Sex: A Cross-Sectional Study.International journal of environmental research and public health · 2025Article
- Global, regional, and national burden of atrial fibrillation and flutter associated with metabolic risk factors, 1990-2021.Frontiers in cardiovascular medicine · 2025Article
- Global burden and health inequality of atrial fibrillation/atrial flutter from 1990 to 2021.Frontiers in cardiovascular medicine · 2025Article
- Making a difference: 5 years of Cardiac Surgery Intersociety Alliance (CSIA).European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Article
- Making a difference: 5 years of Cardiac Surgery Intersociety Alliance (CSIA).Asian cardiovascular & thoracic annals · 2024Article
- Global, regional, and national burdens of atrial fibrillation/flutter from 1990 to 2019: An age-period-cohort analysis using the Global Burden of Disease 2019 study.Journal of global health · 2023Article
- Assessing the knowledge of medical undergraduates on oral anticoagulation therapy.Journal of family medicine and primary care · 2023Article
- Stroke in Sierra Leone: Case fatality rate and functional outcome after stroke in Freetown.International journal of stroke : official journal of the International Stroke Society · 2023Article
- Profile and outcome of patients with Warfarin Toxicity admitted in a tertiary care hospital in Bhutan: a cross-sectional study investigators and institutions.BMC research notes · 2023Review
- Global burden of atrial fibrillation/flutter due to high systolic blood pressure from 1990 to 2019: estimates from the global burden of disease study 2019.Journal of clinical hypertension (Greenwich, Conn.) · 2022Article
- Global Oral Anticoagulation Use Varies by Region in Patients With Recent Diagnosis of Atrial Fibrillation: The GLORIA-AF Phase III Registry.Journal of the American Heart Association · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
With increasing life-expectancy and changing demographics, non-valvular atrial fibrillation (AF) is currently the most common indication for long-term oral anticoagulation (OAC) in low and middle income countries (LMICs). Due to a decreasing trend in the prevalence of rheumatic heart disease (RHD), valve disease as a primary cause of AF now constitutes a small fraction of all people with AF. Moreover, emerging data also indicate that, patients with significant valve disease and AF may have a risk of stroke similar to, if not lower than, those with non-valvular AF. Previous trials of anticoagulation for AF excluded people from LMICs partly because valvular AF constituted a large proportion of those with AF, and it was thought to confer a prohibitively high risk of stroke. Trialists should therefore be less reluctant to include patients with AF from LMICs in general, and those with valve disease in particular, in future trials of anticoagulation. The quality of vitamin K antagonist based oral anticoagulation remains poor in LMICs to a large extent because of poor monitoring. The widespread use of the direct oral anticoagulants (DOAC) presents a practical approach to improve anticoagulation quality. Randomised trials of DOACs in valvular AF are particularlycriticalto bridge the knowledge gap in this area. Discussions regarding oral anticoagulation (OAC) use in low and middle income countries (LMICs) have historicallybeendominated by severallong-held beliefs. The first is that the quality of vitamin K antagonist (VKA) based anticoagulation is poor in these countries. The veracity of this assumption is supported by a large number of studies documenting both lower prescription of OACs, and a lower proportion of international normalised ratio (INR) values in the therapeutic range.
Indexed as
Identifiers
What OpenQuestion holds
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.