Evidence map›Paper›PMID 34280330›Full record

ArticleAnnals of internal medicine2021

Frailty and Clinical Outcomes of Direct Oral Anticoagulants Versus Warfarin in Older Adults With Atrial Fibrillation : A Cohort Study.

Dae Hyun Kim, Ajinkya Pawar, Joshua J Gagne, Lily G Bessette, Hemin Lee, Robert J Glynn, Sebastian Schneeweiss

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

68 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Article
  9. When Fixed-Dose Anticoagulation Meets Frailty.Journal of the American Geriatrics Society · 2026
    Article
  10. Article
  11. Observational
  12. Article
  13. Review
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  15. Article
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  20. Vascular access and closure management for electrophysiological interventions in 2025: a Clinical Consensus Statement of the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions of the ESC, and the ESC Working Group on Cardiovascular Surgery.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 · 2025
    Article

8 more citing papers are in PubMed but not listed here.

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

7 authors.

Dae Hyun KimBrigham and Women's Hospital, Harvard Medical School, Hebrew SeniorLife, and Beth Israel Deaconess Medical Center, Boston, Massachusetts (D.H.K.).ORCID 0000-0001-7290-6838
Ajinkya PawarBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.P., J.J.G., L.G.B., H.L., R.J.G., S.S.).
Joshua J GagneBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.P., J.J.G., L.G.B., H.L., R.J.G., S.S.).
Lily G BessetteBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.P., J.J.G., L.G.B., H.L., R.J.G., S.S.).ORCID 0000-0003-1088-8579
Hemin LeeBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.P., J.J.G., L.G.B., H.L., R.J.G., S.S.).
Robert J GlynnBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.P., J.J.G., L.G.B., H.L., R.J.G., S.S.).
Sebastian SchneeweissBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.P., J.J.G., L.G.B., H.L., R.J.G., S.S.).ORCID 0000-0003-2575-467X

Funding

Prospective Monitoring of Newly Approved Cardiovascular Drugs in Older Adults with FrailtyR01AG062713 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI KIM, DAE HYUN · 2019 to 2022
$2.8M
Development and Validation of a Frailty Index Using Claims Data for Pharmacoepidemiologic Studies in Older AdultsK08AG051187 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI KIM, DAE HYUN · 2015 to 2017
$636k
NIA NIH HHS K08 AG051187NIA NIH HHS R01 AG062713
6 · The paper itself

Abstract

backgroundThe role of differing levels of frailty in the choice of oral anticoagulants for older adults with atrial fibrillation (AF) is unclear.

objectiveTo examine the outcomes of direct oral anticoagulants (DOACs) versus warfarin by frailty levels.

design1:1 propensity score-matched analysis of Medicare data, 2010 to 2017.

settingCommunity. PATIENTS: Medicare beneficiaries with AF who initiated use of dabigatran, rivaroxaban, apixaban, or warfarin. MEASUREMENTS: Composite end point of death, ischemic stroke, or major bleeding by frailty levels, defined by a claims-based frailty index.

resultsIn the dabigatran-warfarin cohort ( LIMITATIONS: Residual confounding and lack of clinical frailty assessment.

conclusionFor older adults with AF, apixaban was associated with lower rates of adverse events across all frailty levels. Dabigatran and rivaroxaban were associated with lower event rates only among nonfrail patients. PRIMARY FUNDING SOURCE: National Institute on Aging.

Indexed as

Frail ElderlyAdministration, OralAgedAnticoagulantsAtrial FibrillationDabigatranFemaleHumansMaleMassachusettsMedicarePropensity ScorePyrazolesPyridonesRetrospective StudiesRivaroxabanAnticoagulantsapixabanDabigatranPyrazolesPyridonesRivaroxabanWarfarin

Identifiers

PMID34280330
PMCPMC8453126

What OpenQuestion holds

Textmetadata
LicenceTDM
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.