Evidence map›Paper›PMID 35476221›Full record

SynthesisCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2022

Novel oral anticoagulants versus vitamin K antagonists in patients with atrial fibrillation after transcatheter aortic valve replacement: A systematic review and meta-analysis.

Muhammad Mustafa Memon, Asad Ali Siddiqui, Emaan Amin, Fahd Niaz Shaikh, Muhammad Shahzeb Khan, Rami Doukky, Richard A Krasuski

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Efficacy and Safety of NOACs Compared With VKAs for Patients With Atrial Fibrillation After Transcatheter Aortic Valve Implantation: A System Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Muhammad Mustafa MemonDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.ORCID 0000-0001-5522-9716
Asad Ali SiddiquiDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Emaan AminDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Fahd Niaz ShaikhDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Muhammad Shahzeb KhanDivision of Cardiology, Duke University Medical Center, Durham, North Carolina, USA.
Rami DoukkyDivision of Cardiology, Cook County Health and Hospitals System, Chicago, Illinois, USA.
Richard A KrasuskiDivision of Cardiology, Duke University Medical Center, Durham, North Carolina, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe efficacy and safety of novel oral anticoagulants (NOACs) compared to the current guideline-recommended vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients undergoing transcatheter aortic valve replacement (TAVR) has not been well established. We pooled evidence from all available studies to assess the risks and benefits of this drug class.

methodsWe queried electronic databases (MEDLINE, Scopus, and Cochrane central) up until January 28th, 2022 for studies comparing NOACs to VKAs in AF patients undergoing TAVR. Results from studies were presented as risk ratios (RR) and pooled using a random-effects model. Subgroup analysis by study design and meta-regression analysis were performed to explore heterogeneity.

resultsA total of 12 studies (3 RCTs and 9 observational) containing 12,203 patients (mean age 81.2 years; 50.5% men) were identified and included in the analysis. Pooled analysis revealed no significant difference between NOACs and VKAs in terms of stroke or systemic embolism (RR: 0.78; p = 0.18), major bleeding (RR: 0.84; p = 0.32), intracranial hemorrhage (RR 0.61; p = 0.06), all-cause mortality (RR: 0.69; p = 0.07), and myocardial infarction (RR: 1.60; p = 0.24) at a mean length of follow-up of 15.1 months. RCTs and observational studies did not significantly differ across outcomes on subgroup analysis. Meta-regression analysis found heterogeneity in all-cause mortality to be significantly explained by percentage of males (coefficient: 0.049, p = 0.007), mean age (coefficient: 0.221, p < 0.001), and CHA2DS2-VASc score (coefficient: -1.657, p < 0.001).

conclusionsThis meta-analysis suggests that outcomes with NOACs do not significantly differ compared to VKAs following TAVR in patients with AF.

Indexed as

Atrial FibrillationStrokeTranscatheter Aortic Valve ReplacementAdministration, OralAged, 80 and overAnticoagulantsFemaleFibrinolytic AgentsHumansMaleTreatment OutcomeVitamin KAnticoagulantsFibrinolytic AgentsVitamin Katrial fibrillationnovel oral anticoagulantstranscatheter aortic valve replacementvitamin K antagonistsWarfarin

Identifiers

PMID35476221

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.