Evidence map›Paper›PMID 34042199›Full record

ArticleClinical cardiology2021

The effect of sex on the efficacy and safety of dual antithrombotic therapy with dabigatran versus triple therapy with warfarin after PCI in patients with atrial fibrillation (a RE-DUAL PCI subgroup analysis and comparison to other dual antithrombotic therapy trials).

David S Eccleston, Joseph M Kim, Jurien M Ten Berg, P Gabriel Steg, Deepak L Bhatt, Stefan H Hohnloser, Anne de Veer, Matias Nordaby, Corinna Miede, Takeshi Kimura and 3 more

Open access · goldAbstract read
In one paragraph

Article in Clinical cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 50% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

13 authors at 10 institutions in 10 countries.

David S EcclestonDepartment of Medicine, University of Melbourne and GenesisCare, Melbourne, Australia.
Joseph M KimBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-6017-6871
Jurien M Ten BergDepartment of Cardiology, St. Antonius Ziekenhuis, Nieuwegein, Netherlands.
P Gabriel StegFACT, an F-CRIN Network, DHU FIRE, Université Paris Diderot, INSERM U_1148 and Hôpital Bichat Assistance Publique, Paris, France.ORCID https://orcid.org/0000-0001-6896-2941
Deepak L BhattBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Stefan H HohnloserJohann Wolfgang Goethe University, Department of Cardiology, Division of Clinical Electrophysiology, Frankfurt am Main, Germany.
Anne de Veer
Matias NordabyBoehringer Ingelheim GmbH, Ingelheim, Germany.
Corinna MiedeMainanalytics GmbH, Sulzbach (Taunus), Germany.
Takeshi KimuraKyoto University, Department of Cardiovascular Medicine, Kyoto, Japan.
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.ORCID https://orcid.org/0000-0002-7566-1626
Jonas OldgrenDepartment of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Christopher P CannonBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-4596-2791
Brigham and Women's Hospital · USBoehringer Ingelheim (Germany) · DEGoethe University Frankfurt · DEInserm · FRKyoto University · JPReference Institute for Bioanalytics · DESt. Antonius Ziekenhuis · NLThe University of Melbourne · AUUniversity of Liverpool · GBUppsala University · SE

Funding

Boehringer Ingelheim
6 · The paper itself

Abstract

backgroundThe RE-DUAL PCI trial demonstrated that in patients with nonvalvular atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI), dual therapy with dabigatran and a P2Y HYPOTHESIS: The reduction in risk of bleeding without increased risk of thromboembolic events with dual therapy with dabigatran and a P2Y

methodsThe primary safety endpoint was the first International Society on Thrombosis and Hemostasis (ISTH) major bleeding event (MBE) or clinically relevant non-major bleeding event (CRNMBE). The efficacy endpoint was the composite of death, thromboembolic event (stroke, myocardial infarction, and systemic embolism) or unplanned revascularization. Cox proportional hazard regression analyses were applied to calculate corresponding hazard ratios and interaction p values for each endpoint.

resultsA total of 655 women and 2070 men were enrolled. The risk of major or CRNM bleeding was lower with both dabigatran 110 mg dual therapy and dabigatran 150 mg dual therapy compared with warfarin triple therapy in female and male patients (for 110 mg: females: HR 0.69, 95% CI 0.47-1.01, males: HR 0.46, 95% CI 0.37-0.59, interaction p value: 0.084 and for 150 mg: females HR 0.74, 95% CI 0.48-1.16, males HR 0.71, 95% CI 0.56-0.90, interaction p value: 0.83). There was also no detectable difference in the composite efficacy endpoint of death, thromboembolic events or unplanned revascularization between dabigatran dual therapy and warfarin triple therapy, with no statistically significant interaction between sex and treatment (interaction p values: 0.73 and 0.72, respectively).

conclusionsConsistent with the overall study results, the risk of bleeding was lower with dabigatran 110 mg and 150 mg dual therapy compared with warfarin triple therapy, and risk of thromboembolic events was comparable with warfarin triple therapy independent of the patient's sex.

Indexed as

Atrial FibrillationCoronary Artery DiseasePercutaneous Coronary InterventionAnticoagulantsDabigatranDrug Therapy, CombinationFemaleFibrinolytic AgentsHumansMalePlatelet Aggregation InhibitorsWarfarinAnticoagulantsDabigatranFibrinolytic AgentsPlatelet Aggregation InhibitorsWarfarindual antithrombotic therapysex differencestriple therapy

Identifiers

PMID34042199
PMCPMC8259156
OpenAlexW3164202043

What OpenQuestion holds

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LicenceCC BY
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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.