Evidence map›Paper›PMID 33997261›Full record

ArticleInternational journal of cardiology. Heart & vasculature2021

Prescribing of two potentially interacting cardiovascular medications in atrial fibrillation patients on direct oral anticoagulants.

Mohammed Shurrab, Maria Koh, Cynthia A Jackevicius, Feng Qiu, Michael Conlon, Joseph Caswell, Karen Tu, Peter C Austin, Dennis T Ko

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

Article in International journal of cardiology. Heart & vasculature, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Association between concurrent use of diltiazem and DOACs and risk of bleeding in atrial fibrillation patients.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023
    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

9 authors at 4 institutions in 2 countries.

Mohammed ShurrabCardiology Department, Health Sciences North, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada.
Maria KohICES, Toronto and North, Ontario, Canada.
Cynthia A JackeviciusInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Feng QiuICES, Toronto and North, Ontario, Canada.
Michael ConlonHealth Sciences North Research Institute, Sudbury, Ontario, Canada.
Joseph CaswellHealth Sciences North Research Institute, Sudbury, Ontario, Canada.
Karen TuInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Peter C AustinInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Dennis T KoInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
University of Toronto · CAHealth Sciences North · CASunnybrook Health Science Centre · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAmiodarone and diltiazem are commonly recommended cardiovascular medications for use in atrial fibrillation (AF) patients. They are known to have drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs). We aimed to evaluate frequency of use of amiodarone or diltiazem among continuous users of DOACs in AF patients and to determine factors associated with their co-use.

methodsThe study population included all AF patients with continuous DOAC use in Ontario, Canada, ≥66 years, from April 1, 2017 to March 31, 2018. Concurrent use of amiodarone or diltiazem was determined by identifying the presence of an overlapping prescription. Multivariable logistic regression models were used to identify predictors of amiodarone or diltiazem use.

resultsIn total, 5,390 AF patients, ≥66 years, with continuous DOAC use were identified. Amiodarone was co-prescribed in 6.4% patients and diltiazem was co-prescribed in 11.2% patients. Prior percutaneous coronary intervention (PCI) and coronary artery bypass surgery (CABG) were associated with significantly increased odds of amiodarone co-use (OR 2.51 [95% CI 1.54, 4.09], p = 0.0002 and OR 5.28 [95% CI 3.52, 7.93], p= <0.001, respectively). Patients with a heart failure (HF) history also had increased co-use of amiodarone (OR 2.05 [95% CI 1.57, 2.67], p < 0.001). The presence of chronic obstructive pulmonary disease (COPD) was associated with significantly increased odds of diltiazem co-use (OR 1.58 [95% CI 1.31, 1.9], p=<0.001).

conclusionsAmong AF patients with continuous DOAC use, amiodarone was co-prescribed in 1 in 16 patients and diltiazem was co-prescribed in 1 in 9 patients. Predictors such as history of HF, PCI, CABG or COPD help identify vulnerable populations at increased risk of DDIs.

Indexed as

Atrial fibrillationDOACsInteractions

Identifiers

PMID33997261
PMCPMC8105295
OpenAlexW3158734909

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.