ReviewCardiovascular drugs and therapy2022
Review Article: Gastrointestinal Bleeding Risk with Direct Oral Anticoagulants.
Review in Cardiovascular drugs and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Safety and Efficacy of Direct Oral Anticoagulants Versus Vitamin K Antagonists for Cerebrovascular Ischemic Outcomes in Non-Valvular Atrial Fibrillation: A Systematic Review and Meta-Analysis.Clinical cardiology · 2026Pooled it
- A single-dose, four-cycle, fully repetitive crossover bioequivalence of dabigatran etexilate in Chinese.BMC pharmacology & toxicology · 2025Trial
- Potentially Clinically Significant Drug-Drug Interactions in Older Adults with Atrial Fibrillation and Multimorbidity: Prevalence, Correlates, and Association with Adverse Clinical Outcomes in a Swedish National Register-Based Study.Cardiovascular drugs and therapy · 2026Article
- Pharmacogenomics of Rivaroxaban: Association ofPharmaceutics · 2026Article
- Severity of Gastrointestinal Bleeding in Anticoagulant Therapy with Vitamin K Antagonist or Direct Oral Anticoagulant Therapy.Journal of general internal medicine · 2026Article
- Warfarin-GPRP: Development and Evaluation of a Novel Warfarin-Based Peptide Conjugate for Enhanced Anticoagulant Activity.ACS omega · 2026Article
- Use of resources and cost in the management of gastrointestinal hemorrhage caused by oral anticoagulants: a retrospective cohort analysis.Cost effectiveness and resource allocation : C/E · 2026Article
- Article
- Real-World Efficacy and Safety of Apixaban vs. Warfarin in Obese Atrial Fibrillation Patients: Propensity Matching Analysis.Biomedicines · 2025Article
- A real-world safety evaluation of new oral anticoagulants in elderly patients: evidence from the Adverse Drug Reaction Monitoring Center of Henan Province.Journal of pharmaceutical policy and practice · 2025Article
- Development and validation of a risk prediction model for new-onset gastrointestinal bleeding in critically ill patients: a retrospective analysis.American journal of translational research · 2025Article
- Apixaban-Induced Esophagitis Dissecans Superficialis-Case Report and Literature Review.Diseases (Basel, Switzerland) · 2024Article
- Real-World Risk of Gastrointestinal Bleeding for Direct Oral Anticoagulants and Warfarin Users: A Distributed Network Analysis Using a Common Data Model.Gut and liver · 2024Article
- Real-World Bleeding Risk of Anticoagulant and Nonsteroidal Anti-inflammatory Drugs Combotherapy versus Anticoagulant Monotherapy.Gut and liver · 2024Article
- Feasibility and acceptability of patient- and clinician-level antithrombotic stewardship interventions to reduce gastrointestinal bleeding risk in patients using warfarin (Anticoagulation with Enhanced Gastrointestinal Safety): a factorial randomized controlled pilot trial.Research and practice in thrombosis and haemostasis · 2024Article
- Acute Nonvariceal Upper Gastrointestinal Bleeding in Patients Using Anticoagulants: Does the Timing of Endoscopy Affect Outcomes?Digestive diseases and sciences · 2024Article
- Exploring bleeding in oral anticoagulant users: assessing incidence by indications and risk factors in the entire nationwide cohort.Frontiers in pharmacology · 2024Article
- Acute upper and lower gastrointestinal bleeding management in older people taking or not taking anticoagulants: a literature review.Frontiers in medicine · 2024Review
- Efficacy and safety of guanxinshutong capsule combined with western medicine on stable angina pectoris: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Review
- Gastrointestinal bleeding among oral anticoagulant users: a comprehensive 7-year retrospective review using Türkiye's national health data system.Turkish journal of medical sciences · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAlthough direct oral anticoagulants (DOACs) are associated with an overall favourable safety profile, the risk of gastrointestinal bleeding with DOACs compared with vitamin K antagonists (VKAs) remains controversial. Accordingly, we aimed to provide a focused overview of the risk of gastrointestinal bleeding associated with dabigatran, rivaroxaban, apixaban and edoxaban and its management.
methodsWe reviewed published studies reporting on DOACs with gastrointestinal bleeding as an outcome, including randomised controlled trials (RCTs), retrospective database studies and large-scale prospective cohort studies.
resultsCumulative evidence confirms no notable difference in major gastrointestinal bleeding risk between DOACs and VKAs. Moreover, gastrointestinal bleeding in DOAC-treated patients seems less severe and requires less intensive management. The main cause of upper gastrointestinal bleeding in DOAC-treated patients appears to be gastroduodenal ulcers, whereas lower gastrointestinal bleedings are mainly due to diverticula followed by angiodysplasia and haemorrhoids. The lack of head-to-head RCTs with DOACs precludes drawing conclusions on the DOAC with the lowest gastrointestinal bleeding risk. Prescribing physicians should be aware of risk factors for DOAC-related gastrointestinal bleeding (e.g. age > 65, heavy alcohol use, uncontrolled hypertension, hepatic or renal dysfunction, active cancer, anaemia) and adopt preventive measures accordingly. Management of DOAC-associated major gastrointestinal bleeding involves temporary discontinuation of the DOAC, investigation of the bleeding source and treatment of bleeding with fluid resuscitation combined with transfusion and endoscopic haemostasis.
conclusionDOACs as a class do not increase the risk of major gastrointestinal bleeding compared to VKAs, which supports their continued use for different anticoagulant indications.
Indexed as
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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.