Evidence map›Paper›PMID 34759208›Full record

ArticleJournal of the Chinese Medical Association : JCMA2022

Network meta-analysis and trial sequential analysis for atrial fibrillation patients receiving PCI or with ACS.

Shu-Mei Yang, Chi-Jung Huang, Chen-Huan Chen, Wen-Chung Yu, Shih-Hsien Sung, Chao-Yu Guo, Shao-Yuan Chuang, Hao-Min Cheng, Chern-En Chiang

Open access · hybridAbstract readNetwork Meta-Analysis
In one paragraph

Article in Journal of the Chinese Medical Association : JCMA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 75% 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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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 1 country.

Shu-Mei YangCenter for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chi-Jung HuangCenter for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chen-Huan ChenDivison of Faculty Development, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Wen-Chung YuDepartment of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Shih-Hsien SungDepartment of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chao-Yu GuoInstitute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Shao-Yuan ChuangInstitute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC.
Hao-Min ChengCenter for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chern-En ChiangDepartment of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Taipei Veterans General Hospital · TWNational Yang Ming Chiao Tung University · TWNational Health Research Institutes · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI), choosing the most appropriate antithrombotic treatment remains a dilemma. We aimed to compare the relative efficacy and safety outcomes of antithrombotic drugs in patients with AF after undergoing PCI or ACS.

methodsRandomized controlled trials were systematically searched on PubMed, EMBASE, and the Cochrane Library. Five studies (11,532 patients) were included in the network meta-analysis. Trial sequential analysis (TSA) was performed to assess the reliability and conclusiveness of the meta-analysis comparing the dual antithrombotic therapy strategies with the triple antithrombotic therapy strategy.

resultsCompared with vitamin K antagonist + dual antiplatelet therapy, novel oral anticoagulant (NOAC) + P2Y12 inhibitor was associated with a significantly better trial-defined primary safety outcome (odds ratio: 0.53; 95% CI, 0.31-0.90) and the lowest probability of thrombolysis in myocardial infarction major bleeding and intracranial hemorrhage using the cumulative ranking technique. In patients omitting aspirin, TSA demonstrated conclusive evidence with significant decreases in all safety outcomes and inconclusive evidence with a nonsignificant increase in in-stent thrombosis (risk ratio: 1.32; TSA-adjusted 95% CI, 0.54-3.24) and myocardial infarction (risk ratio: 1.19; TSA-adjusted 95% CI, 0.84-1.68).

conclusionsIn patients with AF receiving PCI or with ACS, NOAC + P2Y12 inhibitor was associated with the lowest bleeding risk but resulted in a statistically nonsignificant, numerically greater risk for stent thrombosis and myocardial infarction, suggesting that triple antithrombotic therapy should still be an option for certain patients at a high risk of stent thrombosis or myocardial infarction.

Indexed as

Percutaneous Coronary InterventionAcute Coronary SyndromeAgedAtrial FibrillationClinical Trials as TopicFemaleHumansMaleRandomized Controlled Trials as Topic

Identifiers

PMID34759208
PMCPMC12755477
OpenAlexW3211469468

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.