Evidence map›Paper›PMID 37452906›Full record

ArticleJournal of thrombosis and thrombolysis2023

Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with atrial fibrillation and advanced kidney disease.

Chia-Chen Hsu, Cheng-Chi Chen, Chian-Ying Chou, Kuan-Hsuan Chen, Sheng-Fan Wang, Shih-Lin Chang, Yuh-Lih Chang

Open access · hybridAbstract readComparative Study
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. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 14% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Anticoagulation in Patients with Chronic Kidney Disease.American journal of nephrology · 2024
    Review
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 1 institution in 1 country.

Chia-Chen HsuDepartment of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taipei, Taiwan.
Cheng-Chi ChenDepartment of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taipei, Taiwan.
Chian-Ying ChouDepartment of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taipei, Taiwan.
Kuan-Hsuan ChenDepartment of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taipei, Taiwan.
Sheng-Fan WangDepartment of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taipei, Taiwan.
Shih-Lin ChangHeart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Yuh-Lih ChangDepartment of Pharmacy, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taipei, Taiwan. vghylchang@gmail.com.ORCID http://orcid.org/0000-0002-9795-1747
National Yang Ming Chiao Tung University · TW

Funding

National Science and Technology Council MOST111-2635-B-075-001Taipei Veterans General Hospital V111B-043, V111EA-017
6 · The paper itself

Abstract

backgroundThe effectiveness and safety of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) and advanced kidney disease (AKD) has not been fully established.

objectivesTo determine the effectiveness and safety related to pooled or specific DOACs to that with warfarin in patients with AF and AKD.

methodsPatients with AF and AKD (estimated glomerular filtration rate < 30 mL/min) who received DOAC or warfarin from July 2011 to December 2020 were retrospectively identified in a medical center in Taiwan. Primary outcomes were hospitalized for stroke/systemic embolism and major bleeding. Secondary outcomes included any ischemia and any bleeding.

resultsA total of 1,011 patients were recruited, of whom 809 (80.0%) were in the DOACs group (15.3% dabigatran, 25.4% rivaroxaban, 25.2% apixaban, and 14.1% edoxaban), and 202 (20.0%) in the warfarin group. DOACs had considerably lower risks of stroke/systemic embolism (adjusted hazard ratio [aHR] 0.29; 95% CI, 0.09-0.97) and any ischemia (aHR, 0.42; 95% CI, 0.22-0.79), but had comparable risks of major bleeding (aHR, 0.99; 95% CI, 0.34-2.92) and any bleeding (aHR, 0.74; 95% CI, 0.50-1.09) than warfarin. Apixaban was linked to considerably lower risks of any ischemia (aHR, 0.13; 95% CI, 0.04-0.48) and any bleeding (aHR, 0.53; 95% CI, 0.28-0.99) than warfarin.

conclusionAmong patients with AF and AKD, DOACs were linked to a lower risk of ischemic events, and apixaban was linked to a lower risk of any ischemia and any bleeding than warfarin.

Indexed as

AnticoagulantsAtrial FibrillationFactor Xa InhibitorsKidney DiseasesWarfarinAdministration, OralAgedAged, 80 and overDabigatranEmbolismFemaleHemorrhageHumansMaleMiddle AgedPyrazolesAnticoagulantsapixabanDabigatranedoxabanFactor Xa InhibitorsPyrazolesPyridinesPyridonesRivaroxabanThiazolesWarfarinAtrial fibrillation (AF)Chronic kidney disease (CKD)Direct oral anticoagulants (DOACs)HemorrhageThrombosisWarfarin

Identifiers

PMID37452906
PMCPMC10550875
OpenAlexW4384406819

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.