Evidence map›Paper›PMID 34645389›Full record

Observational studyBMC cardiovascular disorders2021

Shifting from vitamin K antagonists to non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: predictors, patterns and temporal trends.

Arthur Shiyovich, Varda Shalev, Gabriel Chodick, Matanya Tirosh, Amos Katz, Miriam M Klar, Mony Shuvy, David Pereg, Sa'ar Minha

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

Observational study in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.5field-weighted citation impact, top 33% 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, 5 citations in OpenAlex.

  1. Article
  2. Charting the Next Road Map for CSF Biomarkers in Alzheimer's Disease and Related Dementias.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
    Review
  3. Article
  4. Article
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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

9 authors at 3 institutions in 2 countries.

Arthur ShiyovichDepartment of Cardiology, Rabin Medical Center, 39 Jabotinsky St., 49100, Petah Tikva, Israel. arthur.shiyovich@gmail.com.ORCID 0000-0001-7316-1882
Varda ShalevSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gabriel ChodickSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Matanya TiroshMedical affairs, Pfizer, Israel.
Amos KatzFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Miriam M KlarSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Mony ShuvyHeart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
David PeregSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sa'ar MinhaSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Tel Aviv University · ILBen-Gurion University of the Negev · ILHadassah Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-Vitamin K antagonist oral anticoagulants (NOACs) emerged as an alternative with comparable or superior efficacy and safety to vitamin K antagonists (VKAs) for stroke prevention in patients with non-valvular atrial fibrillation (AF).

objectivesThe aim of the current study was to investigate the patterns, predictors, timelines and temporal trends of shifting from VKAs to NOACs.

methodsIn this retrospective observational study, the computerized database of a large healthcare provider in Israel, Maccabi Healthcare Services, was searched to identify patients with AF for whom either a VKA or NOAC was prescribed between 2012 and 2015. Time from diagnosis to therapy initiation and to shifting between therapies was evaluated.

resultsOut of 6987 eligible AF incident patients, 2338 (33.4%) initiated treatment with a VKA and 2221 (31.7%) with a NOAC. In addition, 5259 prevalent patients were analyzed. During the study period, NOAC prescriptions proportion among the newly diagnosed cases increased from 32 to 68.4% (p for trend <  0.001). The median time from diagnosis to first dispensing was greater in NOAC than VKA and decreased among patients treated with NOAC during the study period (2012: 1.9 and 0.3 months, 2015: 0.7 and 0.2 months, respectively). During follow-up, 3737 (49%) patients (54.3% and 47.1% of the incident and prevalent cases, respectively), shifted from a VKA to a NOAC, after a median of 22 months and 39 months in the incident and prevalent cases, respectively, decreasing throughout the study period. Female gender, younger age, southern district, higher CHADS

conclusionsShifting from VKA to NOAC occurred in 50% of the cases, more frequently among incident cases, and younger patients with greater stroke risk. Shifting from a NOAC to a VKA was much less frequent, yet it occurred more often in incident cases and decreased over time. A socially and economically sensitive program to optimize the initiation of OAC therapy upon diagnosis is warranted.

Indexed as

Administration, OralAgedAged, 80 and overAge FactorsAnticoagulantsAtrial FibrillationClinical Decision-MakingDatabases, FactualDrug SubstitutionDrug UtilizationFemaleHumansIncidenceIsraelMaleMiddle AgedAnticoagulantsVitamin KAtrial fibrillationNon-vitamin K antagonist oral anticoagulantsShiftingTime to initiationvitamin-k antagonists

Identifiers

PMID34645389
PMCPMC8513259
OpenAlexW3205280311

What OpenQuestion holds

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Registered trials

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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.