Evidence map›Paper›PMID 36318378›Full record

ArticleJournal of thrombosis and thrombolysis2023

TAVR: nemesis of NOACs?

Amin Polzin, Carolin Helten, Daniel Metzen, Saif Zako, Verena Veulemans, Malte Kelm, Tobias Zeus

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thrombosis and thrombolysis, 2023. 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 74% 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

7 authors at 2 institutions in 1 country.

Amin Polzin *Division of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany. amin.polzin@med.uni-duesseldorf.de.
Carolin Helten *Division of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.ORCID http://orcid.org/0000-0001-8066-2239
Daniel MetzenDivision of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
Saif ZakoDivision of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
Verena VeulemansDivision of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
Malte KelmDivision of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
Tobias ZeusDivision of Cardiology, Pulmonology, and Vascular Medicine, Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
Heinrich Heine University Düsseldorf · DEDüsseldorf University Hospital · DE

Funding

Forschungskommission of the Medical Faculty of the Heinrich Heine University Duesseldorf 18-2019Forschungskommission of the Medical Faculty of the Heinrich Heine University Duesseldorf 51-2020German Research Foundation PO 2247/2-1German Research Foundation SFB1116
6 · The paper itself

Abstract

Data on non-vitamin K antagonist oral anticoagulants (NOACs) in transcatheter aortic valve replacement (TAVR) patients are controversial. In patients without atrial fibrillation (AF), rivaroxaban showed enhanced ischemia and bleeding as compared to standard of care. ENVISAGE showed enhanced bleeding in AF patients as compared to vitamin K antagonist (VKA). Only apixaban was non-inferior but failed superiority regarding bleeding in AF patients after TAVR. One could hypothesize that this might be due to pharmacokinetics of NOACs. Therefore, we compared outcome in rivaroxaban/edoxaban (once-daily) and apixaban (twice-daily) treated patients. 568 patients with indication for permanent oral anticoagulation due to AF undergoing TAVR were analyzed via inverse probability of treatment weighting. Valve academic research consortium complications during 30-day follow-up were assessed. Bleeding complications were similar in once-daily and twice-daily NOACs (major: 22 (7.5%) vs. 14 (5.3%), p = 0.285; minor: 66 (22.4%) vs. 46 (17.4%), p = 0.133). Complications did not change when splitting the cohort in the different agents apixaban, rivaroxaban and edoxaban. These findings remained robust after multivariate analysis. In summary, twice-daily and once-daily NOACs did not differ regarding bleeding complications in a hypothesis generating real-world cohort of TAVR patients with AF.

Indexed as

Atrial FibrillationStrokeTranscatheter Aortic Valve ReplacementAdministration, OralAnticoagulantsFibrinolytic AgentsHemorrhageHumansPyridinesRivaroxabanThiazolesTreatment OutcomeAnticoagulantsedoxabanFibrinolytic AgentsPyridinesRivaroxabanThiazolesBleedingNOACTAVR

Identifiers

PMID36318378
PMCPMC9925602
OpenAlexW4307834346

What OpenQuestion holds

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LicenceCC BY
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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.