Evidence map›Paper›PMID 36831090›Full record

ReviewBiomedicines2023

No Association between Gastrointestinal Rebleeding and DOAC Therapy Resumption: A Systematic Review and Meta-Analysis.

Dániel Pálinkás, Brigitta Teutsch, Endre Botond Gagyi, Marie Anne Engh, Patrícia Kalló, Dániel S Veres, László Földvári-Nagy, Nóra Hosszúfalusi, Péter Hegyi, Bálint Erőss

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PubMed Full text at PMC Publisher
In one paragraph

Review in Biomedicines, 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
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.

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

10 authors.

Dániel PálinkásCentre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary.ORCID 0000-0001-5578-1754
Brigitta TeutschCentre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary.ORCID 0000-0002-9530-7886
Endre Botond GagyiCentre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary.
Marie Anne EnghCentre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary.
Patrícia KallóInstitute for Translational Medicine, Medical School, University of Pécs, H-7622 Pécs, Hungary.
Dániel S VeresCentre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary.ORCID 0000-0002-9687-3556
László Földvári-NagyDepartment of Morphology and Physiology, Faculty of Health Science, Semmelweis University, H-1088 Budapest, Hungary.
Nóra HosszúfalusiDepartment of Internal Medicine and Haematology, Semmelweis University, H-1088 Budapest, Hungary.
Péter HegyiCentre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary.
Bálint ErőssCentre for Translational Medicine, Semmelweis University, H-1085 Budapest, Hungary.ORCID 0000-0003-3658-8427

Funding

Innovációs és Technológiai Minisztérium National Research, Development and Innovation Fund TKP2021-EGA-23
6 · The paper itself

Abstract

backgroundThere are recommendations for anticoagulation resumption after gastrointestinal bleeding (GIB), although data addressing this topic by direct oral anticoagulants (DOACs)-treated patients is lacking. We aim to determine the safety and efficacy of restarting DOACs after GIB.

methodsStudies that reported rebleeding, thromboembolic events, and mortality after restarting or withholding DOACs were selected. The systematic research was conducted in five databases (MEDLINE, EMBASE, CENTRAL, Web of Science, and Scopus). The random effect model was implemented to calculate the pooled odds ratio (OR). The ROBINS-I tool was used for risk of bias assessment, and the certainty of the evidence was evaluated with the GRADE approach.

resultsFour retrospective cohort studies (1722 patients) were included in the meta-analysis. We did not find a significant increase in the risk of rebleeding in patients restarting DOACs after index GIB (OR = 1.12; 95% CI: 0.74-1.68). The outcomes of thromboembolic events and mortality data were not suitable for meta-analytic calculations. Single studies did not show statistically significant differences. Data quality assessment showed a serious overall risk of bias and very low quality of evidence (GRADE D).

conclusionDOAC resumption after a GIB episode may not elevate the risk of rebleeding. However, the need for high-quality randomized clinical trials is crucial.

Indexed as

efficacygastrointestinal hemorrhagenon-vitamin K antagonist oral anticoagulant (NOAC)safetytherapy resumption

Identifiers

PMID36831090
PMCPMC9953612

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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.