Evidence map›Paper›PMID 35364622›Full record

ArticlePharmacotherapy2022

Use of oral anticoagulants among individuals with cancer and atrial fibrillation in the United States, 2010-2016.

Shirin Ardeshirrouhanifard, Huijun An, Ravi K Goyal, Mukaila A Raji, Jodi B Segal, G Caleb Alexander, Hemalkumar B Mehta

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pharmacotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–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

11 citing papers in PubMed.

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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

7 authors.

Shirin ArdeshirrouhanifardCenter for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Huijun AnCenter for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Ravi K GoyalCollege of Pharmacy, University of Houston, Houston, Texas, USA.
Mukaila A RajiDepartment of Internal Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.
Jodi B SegalCenter for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
G Caleb AlexanderCenter for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Hemalkumar B MehtaCenter for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID 0000-0001-9134-6370

Funding

NHLBI Training Program in PharmacoepidemiologyT32HL139426 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI G. Caleb Alexander, JODI B. SEGAL · 2018 to 2026
$2.5M
Towards Understanding the Patient Experience of Overuse of Medical ResourcesK24AG049036 · NIA · JOHNS HOPKINS UNIVERSITY · PI SEGAL, JODI B. · 2015 to 2024
$1.6M
Drug-Drug Interactions Involving Direct-Acting Oral Anticoagulants in Nursing Home ResidentsK01AG070329 · NIA · JOHNS HOPKINS UNIVERSITY · PI MEHTA, HEMALKUMAR B. · 2021 to 2025
$647k
NHLBI NIH HHS T32 HL139426NIA NIH HHS K01 AG070329NIA NIH HHS K24 AG049036NIH HHS 1K01AG070329NIH HHS K24AG049036
6 · The paper itself

Abstract

backgroundAnticoagulation among patients with cancer and atrial fibrillation is challenging due to elevated risk of bleeding and stroke. We characterized use of oral anticoagulants among patients with cancer and non-valvular atrial fibrillation (NVAF).

methodsWe used Surveillance, Epidemiology, and End Results (SEER)-Medicare data and included patients with cancer aged ≥66 years with an incident diagnosis of NVAF from 2010 to 2016. We used a Cox proportional hazard model and multivariable logistic regression to identify factors associated with anticoagulant use versus no use and direct oral anticoagulants (DOACs) versus warfarin use, respectively.

resultsOf 27,702 patients with cancer and NVAF, 4469 (16.1%) used DOACs and 3577 (12.9%) used warfarin. Among 8046 anticoagulant users, DOACs use increased from 21.8% in 2011 to 76.2% in 2016, with a corresponding decline in warfarin use from 78.2% to 23.8%. Nearly 7 out of 10 patients with cancer and NVAF did not initiate anticoagulation in 2016. Anticoagulant use was more likely among those with higher CHA₂DS₂-VASc scores (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.27-1.90 for score ≥6 vs. 1) or with lower HAS-BLED scores (HR 1.96, 95% CI 1.67-2.30 for score 1 vs. ≥6). Among anticoagulant users, DOAC use was less likely than warfarin in those with higher CHA₂DS₂-VASc scores (odds ratio [OR] 0.53, 95% CI 0.33-0.84 for score ≥6 vs. 1).

conclusionsNearly 7 out of 10 patients with cancer and NVAF did not receive anticoagulation. Use of DOACs increased from 2010 to 2016, with a corresponding decline in warfarin use. DOACs are used less than warfarin among those at higher risk of stroke.

Indexed as

Atrial FibrillationNeoplasmsStrokeAdministration, OralAgedAnticoagulantsHemorrhageHumansMedicareRetrospective StudiesUnited StatesWarfarinAnticoagulantsWarfarinanticoagulationatrial fibrillationcancerdirect-acting oral anticoagulants

Identifiers

PMID35364622
PMCPMC9302858

What OpenQuestion holds

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LicenceCC BY-NC
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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.