ArticleThrombosis and haemostasis2024
The Impact of Polypharmacy on the Effectiveness and Safety of Non-vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation.
Article in Thrombosis and haemostasis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 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
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Pooled it
- 2024 Chinese Expert Consensus Guidelines on the Diagnosis and Treatment of Atrial Fibrillation in the Elderly, Endorsed by Geriatric Society of Chinese Medical Association (Cardiovascular Group) and Chinese Society of Geriatric Health Medicine (Cardiovascular Branch): Executive Summary.Thrombosis and haemostasis · 2024Guideline
- Efficacy of the ABC Pathway for Integrated Care Across Phenotypes of Patients with Atrial Fibrillation: A Latent-Class Analysis Report from the mAFA-II Clinical Trial.Journal of general internal medicine · 2025Trial
- Renal function and adverse clinical events in anticoagulated patients with atrial fibrillation: insights from the GLORIA-AF Registry Phase III.Journal of thrombosis and thrombolysis · 2025Trial
- Observational
- [Determinants of bleeding risk in anticoagulated patients in primary care: A retrospective observational study].Atencion primaria · 2026Article
- Multimorbidity Status Worsening and Clinical Outcomes of Patients With Atrial Fibrillation.JACC. Asia · 2026Article
- Definition of Polypharmacy in Atrial Fibrillation and Atrial Flutter: A Scoping Review.Cardiology research · 2026Review
- Triple Therapy With Rivaroxaban in Patients With Acute Myocardial Infarction and Prior Atrial Fibrillation.Pacing and clinical electrophysiology : PACE · 2026Article
- Patterns of deprescribing after an emergency department visit due to adverse drug events among concomitant users of antithrombotics and other medications.medRxiv : the preprint server for health sciences · 2026Article
- Optimizing cardiovascular pharmacotherapy in older adults with frailty.Nature reviews. Cardiology · 2026Review
- Comorbidity and medication patterns in atrial fibrillation patients: association with adverse clinical outcomes.Internal and emergency medicine · 2025Article
- Multimorbidity and atrial fibrillation: Envisioning integrated approaches to complex health needs.International journal of cardiology. Heart & vasculature · 2025Article
- Early Rhythm Control of Atrial Fibrillation in Cancer Survivors: A Nationwide Population-Based Study.Journal of the American Heart Association · 2025Observational
- Hemorrhagic Stroke in Atrial Fibrillation: Trends in Incidence, Case Fatality, and Prior Oral Anticoagulation.Journal of the American Heart Association · 2025Article
- Residual Risks of Thrombotic Complications in Anticoagulated Patients with Atrial Fibrillation: A Cluster Analysis Approach from the GLORIA-AF Registry.Journal of general internal medicine · 2025Article
- Low incidence of thromboembolism with Fiix-monitored warfarin compared to conventional warfarin and DOACs in patients with AF.Blood vessels, thrombosis & hemostasis · 2025Article
- The Prevalence and Impact of Atrial Fibrillation on Patients with Chronic Total Occlusions: Insights from the National Inpatient Sample.Journal of cardiovascular development and disease · 2025Article
- Long-term risks and benefits of oral anticoagulation in atrial fibrillation patients with cancer: A report from the GLORIA-AF registry.European journal of clinical investigation · 2025Article
- Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III.BMC medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundPolypharmacy may affect outcomes in patients with atrial fibrillation (AF) using non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) due to interactions or reduced adherence, but comparative data are lacking. Therefore, the impact of polypharmacy on AF-related outcomes and benefit-risk profiles of NOACs in patients with polypharmacy were investigated.
methodsAF patients initiating anticoagulation between 2013 and 2019 were included using Belgian nationwide data. Inverse probability of treatment weighted Cox regression was used to investigate outcomes.
resultsAmong 254,478 AF patients, 167,847 (66.0%) used ≥5 drugs. Polypharmacy was associated with higher stroke or systemic embolism (stroke/SE) (adjusted hazard ratio [aHR]: 1.08, 95% confidence interval [CI]: 1.02-1.15), all-cause mortality (aHR: 1.45, 95% CI: 1.40-1.50), and major bleeding risks (aHR: 1.29, 95% CI: 1.23-1.35). Among patients with polypharmacy, NOACs were associated with lower stroke/SE (aHR: 0.68, 95% CI: 0.63-0.73), all-cause mortality (aHR: 0.80, 95% CI: 0.77-0.84), major bleeding (aHR: 0.92, 95% CI: 0.87-0.97), and intracranial bleeding risks (aHR: 0.77, 95% CI: 0.69-0.85), but higher gastrointestinal bleeding risks (aHR: 1.10, 95% CI: 1.01-1.19) compared to VKAs. Major bleeding risks were lower with apixaban (aHR: 0.79, 95% CI: 0.74-0.85), but nonsignificantly different with other NOACs compared to VKAs. Lower major bleeding risks were observed with dabigatran (aHR: 0.91, 95% CI: 0.85-0.97) and apixaban (aHR: 0.77, 95% CI: 0.73-0.81) compared to rivaroxaban, and with apixaban compared to dabigatran (HR: 0.83, 95% CI: 0.77-0.90) and edoxaban (HR: 0.77, 95% CI: 0.70-0.85).
conclusionPolypharmacy was associated with increased thromboembolic, bleeding, and mortality risks in AF patients. NOACs had better benefit-risk profiles than VKAs in patients with polypharmacy.
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.