SynthesisJournal of the American College of Cardiology2023
Direct Oral Anticoagulants vs Vitamin K Antagonists in Patients With Antiphospholipid Syndromes: Meta-Analysis of Randomized Trials.
Synthesis in Journal of the American College of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 6 of them syntheses that pooled 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.
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
71 citing papers in PubMed, 6 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- Anticoagulation approaches in hemodialysis: a systematic review of efficacy, safety, and literature gap.International urology and nephrology · 2026Pooled it
- Antithrombotic therapy for secondary stroke prevention in patients with cancer: a systematic review and network meta-analysis.European journal of clinical pharmacology · 2025Pooled it
- Direct oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Pooled it
- Therapy with direct oral anticoagulants for secondary prevention of thromboembolic events in the antiphospholipid syndrome: a systematic review and meta-analysis of randomised trials.Lupus science & medicine · 2023Pooled it
- Managing Anticoagulation and Dual Antiplatelet Therapy in Patients with Active Bleed or Upcoming Procedure: A Scoping Review.Journal of Brown hospital medicine · 2023Pooled it
- Evaluating the Efficacy and Safety of Direct Oral Anticoagulants Compared to Vitamin K Antagonists in Patients with Antiphospholipid Syndrome: Updated Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Autoimmune-associated thrombosis: mechanisms, population burden, and prevention strategies.The Lancet regional health. Europe · 2026Review
- Antiphospholipid antibodies and cardiovascular thrombosis.Nature reviews. Cardiology · 2026Review
- OFDI-Guided Stentless PCI for Erosion-Related STEMI Unmasking Antiphospholipid Syndrome.JACC. Case reports · 2026Article
- A comprehensive multicenter study assessing the impact of abelacimab, asundexian, and milvexian on coagulation assays.Blood advances · 2026Article
- Management and outcomes in patients with cryptogenic stroke and weakly positive antiphospholipid antibodies.Research and practice in thrombosis and haemostasis · 2026Article
- Article
- Anticoagulation, recurrent thrombosis, and major bleeding in antiphospholipid syndrome: UK multicenter observational study.Blood advances · 2026Observational
- Small-molecule inhibition of γ-glutamyl carboxylase reveals a novel anticoagulant strategy.Blood advances · 2026Article
- Implementing anticoagulation stewardship: the use of a dedicated mobile phone 'app' in the experience of the Italian Federation of Anticoagulation linics (FCSA).Journal of thrombosis and thrombolysis · 2026Article
- Do Patients with Antiphospholipid Syndrome Present with More Significant Venous Thromboembolic Clot Burden? A Retrospective Single-Center Study.Hematology reports · 2026Article
- Article
- Long-term efficacy and safety of direct oral anticoagulants in venous thrombotic antiphospholipid syndrome patients not candidate to warfarin: A pilot prospective case series study.Journal of thrombosis and thrombolysis · 2026Article
- Gut-Brain Axis Dysregulation in Inflammatory Bowel Disease: Implications for Coagulation Abnormalities and Extraintestinal Manifestations.International journal of general medicine · 2026Review
- Direct Oral Anticoagulant Inhibitors: Mode of Action, Clinical Aspects.Handbook of experimental pharmacology · 2026Review
11 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
18 authors at 14 institutions in 4 countries.
Funding
Abstract
backgroundThe efficacy and safety of direct oral anticoagulants (DOACs) for patients with thrombotic antiphospholipid syndrome remain controversial.
objectivesThe authors performed a systematic review and meta-analysis of randomized controlled trials that compared DOACs with vitamin K antagonists (VKAs).
methodsWe searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials through April 9, 2022. The 2 main efficacy outcomes were a composite of arterial thrombotic events and venous thromboembolic events (VTEs). The main safety outcome was major bleeding. Random effects models with inverse variance were used.
resultsOur search retrieved 253 studies. Four open-label randomized controlled trials involving 472 patients were included (mean control-arm time-in-therapeutic-range 60%). All had proper random sequence generation and adequate allocation concealment. Overall, the use of DOACs compared with VKAs was associated with increased odds of subsequent arterial thrombotic events (OR: 5.43; 95% CI: 1.87-15.75; P < 0.001, I
conclusionsPatients with thrombotic antiphospholipid syndrome randomized to DOACs compared with VKAs appear to have increased risk for arterial thrombosis. No significant differences were observed between patients randomized to DOACs vs VKAs in the risk of subsequent VTE or major bleeding.
Indexed as
Identifiers
What OpenQuestion holds
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.