Observational studyEuropean heart journal2022
Oral anticoagulants in patients with atrial fibrillation at low stroke risk: a multicentre observational study.
Observational study in European heart journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
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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
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Sex-specific comparative outcomes between oral anticoagulants in patients with atrial fibrillation: a systematic review and meta-analysis.Open heart · 2024Pooled it
- Oral Anticoagulation Therapy in Atrial Fibrillation Patients with Intermediate Stroke Risk: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Oral Anticoagulant Therapy in Patients with Atrial Fibrillation After Intracranial Hemorrhage: A Meta-Analysis of Randomized Controlled Trials.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Efficacy and safety of direct oral anticoagulants for intermediate stroke risk in patients with atrial fibrillation (SINGLE-AF): Study design and protocol.Heart rhythm O2 · 2026Article
- Estimating the Stroke Risk Threshold for Initiating Non-Vitamin K Antagonist Oral Anticoagulation in Atrial Fibrillation: Markov Decision Model Analysis.Circulation. Cardiovascular quality and outcomes · 2025Article
- Explainable artificial intelligence for stroke risk stratification in atrial fibrillation.European heart journal. Digital health · 2025Review
- Edoxaban treatment in routine clinical practice is highly concordant with the 2020 European Society of Cardiology atrial fibrillation guidelines: results from the noninterventional Global ETNA-AF programme.European heart journal open · 2025Article
- Impact of preprocedural anticoagulation on the incidence of silent cerebral embolisms after catheter ablation of atrial fibrillation in patients with low thromboembolic risk.Frontiers in cardiovascular medicine · 2025Article
- Atrial Fibrillation Already Known Versus Detected After Stroke: Same Battle?Journal of the American Heart Association · 2024Article
- Clinical case of Cor triatriatum sinister, a dilemma of anticoagulation: A case report and literature review.Clinical case reports · 2024Article
- How is inflammation biology truly associated with depression in patients with stable coronary heart disease?: Insights from the heart and Soul study.Brain, behavior, & immunity - health · 2024Article
- Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation.Journal of geriatric cardiology : JGC · 2024Article
- Limitations in Contemporary Pharmacological Stroke Prevention Therapies in Atrial Fibrillation: A Descriptive Literature Review.Journal of clinical medicine · 2023Review
- Oral Anticoagulant Use in Patients with Atrial Fibrillation at Low Risk of Stroke and Associated Bleeding Complications.Journal of clinical medicine · 2023Article
- Biological Risk Factors Influencing Vascular Cognitive Impairments: A Review of the Evidence.Brain sciences · 2023Review
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 5 countries.
Funding
Abstract
aimsThere is currently no consensus on whether atrial fibrillation (AF) patients at low risk for stroke (one non-sex-related CHA2DS2-VASc point) should be treated with an oral anticoagulant. METHODS AND
resultsWe conducted a multi-country cohort study in Sweden, Denmark, Norway, and Scotland. In total, 59 076 patients diagnosed with AF at low stroke risk were included. We assessed the rates of stroke or major bleeding during treatment with a non-vitamin K antagonist oral anticoagulant (NOAC), a vitamin K antagonist (VKA), or no treatment, using inverse probability of treatment weighted (IPTW) Cox regression. In untreated patients, the rate for ischaemic stroke was 0.70 per 100 person-years and the rate for a bleed was also 0.70 per 100 person-years. Comparing NOAC with no treatment, the stroke rate was lower [hazard ratio (HR) 0.72; 95% confidence interval (CI) 0.56-0.94], and the rate for intracranial haemorrhage (ICH) was not increased (HR 0.84; 95% CI 0.54-1.30). Comparing VKA with no treatment, the rate for stroke tended to be lower (HR 0.81; 95% CI 0.59-1.09), and the rate for ICH tended to be higher during VKA treatment (HR 1.37; 95% CI 0.88-2.14). Comparing NOAC with VKA treatment, the rate for stroke was similar (HR 0.92; 95% CI 0.70-1.22), but the rate for ICH was lower during NOAC treatment (HR 0.63; 95% CI 0.42-0.94).
conclusionThese observational data suggest that NOAC treatment may be associated with a positive net clinical benefit compared with no treatment or VKA treatment in patients at low stroke risk, a question that can be tested through a randomized controlled trial.
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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.