Evidence map›Paper›PMID 34604802›Full record

ArticleJACC. CardioOncology2021

Effectiveness and Safety of Oral Anticoagulants Among Nonvalvular Atrial Fibrillation Patients With Active Cancer.

Steven Deitelzweig, Allison V Keshishian, Yan Zhang, Amiee Kang, Amol D Dhamane, Xuemei Luo, Christian Klem, Mauricio Ferri, Jenny Jiang, Huseyin Yuce and 1 more

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

Article in JACC. CardioOncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
7.1field-weighted citation impact, top 2% 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

26 citing papers in PubMed, 49 citations in OpenAlex.

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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

11 authors at 4 institutions in 3 countries.

Steven DeitelzweigOchsner Clinic Foundation, Department of Hospital Medicine, New Orleans, Louisiana, USA.
Allison V KeshishianSTATinMED Research, Ann Arbor, Michigan, USA.
Yan ZhangBristol Myers Squibb Company, Lawrenceville, New Jersey, USA.
Amiee KangBristol Myers Squibb Company, Lawrenceville, New Jersey, USA.
Amol D DhamaneBristol Myers Squibb Company, Lawrenceville, New Jersey, USA.
Xuemei LuoPfizer, Inc., Groton, Connecticut, USA.
Christian KlemBristol Myers Squibb Company, Lawrenceville, New Jersey, USA.
Mauricio FerriBristol Myers Squibb Company, Lawrenceville, New Jersey, USA.
Jenny JiangBristol Myers Squibb Company, Lawrenceville, New Jersey, USA.
Huseyin YuceNew York City College of Technology, City University of New York, New York, New York, USA.
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.
Liverpool Heart and Chest Hospital · GBNew York City College of Technology · USPfizer (United States) · USSTATinMED (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with cancer are more likely to develop nonvalvular atrial fibrillation (NVAF). Currently there are no definitive clinical trials or treatment guidelines for NVAF patients with concurrent cancer.

objectivesThis subgroup analysis of the ARISTOPHANES study compared the risk of stroke/systemic embolism (stroke/SE) and major bleeding (MB) among NVAF patients with active cancer who were prescribed non-vitamin K antagonist oral anticoagulants (NOACs) or warfarin.

methodsA retrospective observational study was conducted in NVAF patients with active cancer who newly initiated apixaban, dabigatran, rivaroxaban, or warfarin from January 1, 2013, through September 30, 2015, with the use of Medicare and 4 U.S. commercial claims databases. Cox models were used to estimate the risk of stroke/SE and MB in the pooled propensity score-matched cohorts.

resultsA total of 40,271 patients were included, with main cancer types of prostate (29%), female breast (17%), genitourinary (14%), and lung (13%). Compared with warfarin, apixaban was associated with a lower risk of stroke/SE (hazard ratio [HR]: 0.59; 95% confidence interval [CI]: 0.45-0.78) and MB (HR: 0.58; 95% CI: 0.50-0.68); dabigatran and rivaroxaban had similar risks of stroke/SE (dabigatran: HR: 0.88 [95% CI: 0.54-1.41]; rivaroxaban: HR: 0.82 [95% CI: 0.62-1.08]) and MB (dabigatran: HR: 0.76 [95% CI: 0.57-1.01]; rivaroxaban: HR: 0.95 [95% CI: 0.85-1.06]). Risks of stroke/SE and MB varied among NOAC-NOAC comparisons, while consistent treatment effects were seen for all treatment comparisons across key cancer types.

conclusionsAmong this cohort of NVAF patients with active cancer, the risk of stroke/SE and MB varied among oral anticoagulants and were consistent across cancer types.

Indexed as

active cancerAF, atrial fibrillationanticoagulantsbleedingGI, gastrointestinalGU, genitourinaryICH, intracranial hemorrhageMB, major bleedingNOAC, non–vitamin K antagonist oral anticoagulantnonvalvular atrial fibrillationNVAF, nonvalvular atrial fibrillationPSM, propensity score matchingSE, systemic embolismstrokeVTE, venous thromboembolism

Identifiers

PMID34604802
PMCPMC8463723
OpenAlexW3200981557

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.