Evidence map›Paper›PMID 36082252›Full record

ArticleEuropean stroke journal2022

Once versus twice daily direct oral anticoagulants in patients with recent stroke and atrial fibrillation.

Alexandros A Polymeris, Annaelle Zietz, Fabian Schaub, Louisa Meya, Christopher Traenka, Sebastian Thilemann, Benjamin Wagner, Lisa Hert, Valerian L Altersberger, David J Seiffge and 14 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European stroke journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03826927 (New Oral Anticoagulants in Stroke Patients-Long Term Prevention of Recurrent Stroke in Patients With Atrial Fibrillation- a National Prospective Registry), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 24% 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.

NCT03826927 completednot on this map

New Oral Anticoagulants in Stroke Patients-Long Term Prevention of Recurrent Stroke in Patients With Atrial Fibrillation- a National Prospective Registry (NOACISP Long Term)

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2013 to 2021Enrolled1,023ConditionsStroke, Atrial FibrillationArmstreatment with NOACs or VKAs
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Review
  6. Article
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

24 authors at 2 institutions in 1 country.

Alexandros A PolymerisDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-9475-2208
Annaelle ZietzDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Fabian SchaubDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-2434-6423
Louisa MeyaDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Christopher TraenkaDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-7600-1005
Sebastian ThilemannDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Benjamin WagnerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0001-9330-1790
Lisa HertDepartment of Intensive Care Medicine, University Hospital Basel and University of Basel, Basel, Switzerland.
Valerian L AltersbergerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-0610-9328
David J SeiffgeDepartment of Neurology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0003-3890-3849
Flurina LyrerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Tolga DittrichDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Ines PiotDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Josefin KaufmannDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Lea BaroneDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Ludvig DahlheimMedical Faculty, University of Basel, Basel, Switzerland.
Sophie FlammerMedical Faculty, University of Basel, Basel, Switzerland.
Nikolaos S AvramiotisDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Nils PetersDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Gian Marco De MarchisDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-0342-9780
Leo H BonatiDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0003-1163-8133
Henrik GensickeDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Stefan T EngelterDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Philippe A LyrerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
University of Basel · CHUniversity of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Data on the safety and effectiveness of once-daily (QD) versus twice-daily (BID) direct oral anticoagulants (DOAC) in comparison to vitamin K antagonists (VKA) and to one another in patients with atrial fibrillation (AF) and recent stroke are scarce. Patients and methods: Based on prospectively obtained data from the observational registry Novel-Oral-Anticoagulants-in-Ischemic-Stroke-Patients(NOACISP)-LONGTERM (NCT03826927) from Basel, Switzerland, we compared the occurrence of the primary outcome - the composite of recurrent ischemic stroke, major bleeding, and all-cause death - among consecutive AF patients treated with either VKA, QD DOAC, or BID DOAC following a recent stroke using Cox proportional hazards regression including adjustment for potential confounders. Results: We analyzed 956 patients (median age 80 years, 46% female), of whom 128 received VKA (13.4%), 264 QD DOAC (27.6%), and 564 BID DOAC (59%). Over a total follow-up of 1596 patient-years, both QD DOAC and BID DOAC showed a lower hazard for the composite outcome compared to VKA (adjusted HR [95% CI] 0.69 [0.48, 1.01] and 0.66 [0.47, 0.91], respectively). Upon direct comparison, the hazard for the composite outcome did not differ between patients treated with QD versus BID DOAC (adjusted HR [95% CI] 0.94 [0.70, 1.26]). Secondary analyses focusing on the individual components of the composite outcome revealed no clear differences in the risk-benefit profile of QD versus BID DOAC. Discussion and conclusion: The overall benefit of DOAC over VKA seems to apply to both QD and BID DOAC in AF patients with a recent stroke, without clear evidence that one DOAC dosing regimen is more advantageous than the other.

Indexed as

atrial fibrillationDirect oral anticoagulantsonce-dailyregimenstroketwice-daily

Identifiers

PMID36082252
PMCPMC9446322
OpenAlexW4280509412

What OpenQuestion holds

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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.