Evidence map›Paper›PMID 37533609›Full record

ReviewCureus2023

Low-Molecular-Weight Heparin Versus Warfarin in Adult Cancer Patients as a Precision Medicine for Thrombosis: A Systematic Review and Meta-Analysis.

Hany A Zaki, Baha Hamdi Alkahlout, Kaleem Basharat, Wael Abdelrehem Elnabawy Elsayed, Mohammed Gafar Abdelrahim, Nood Dhafi R Al-Marri, Maarij Masood, Eman Shaban

Open access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 7% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Statins for adults with a first episode of venous thromboembolic disease.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Review
  3. Review
  4. Review
  5. Pulmonary Embolism in Long Standing Diabetes: A Hint Towards Pancreatic Carcinoma.Journal of community hospital internal medicine perspectives · 2025
    Article
  6. 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

8 authors at 1 institution in 1 country.

Hany A ZakiEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Baha Hamdi AlkahloutEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Kaleem BasharatEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Wael Abdelrehem Elnabawy ElsayedEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Mohammed Gafar AbdelrahimEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Nood Dhafi R Al-MarriEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Maarij MasoodEmergency Medicine, Hamad Medical Corporation, Doha, QAT.
Eman ShabanCardiology, Al Jufairi Diagnosis and Treatment, Doha, QAT.
Hamad Medical Corporation · QA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Venous thromboembolism (VTE) is a condition often seen in patients diagnosed with cancer and is recognized as a predictor of poor outcomes in these patients. The probability of VTE recurring is generally higher in people with cancer than in those without; hence, addressing this issue is essential when making healthcare decisions. Therefore, our systematic review was primarily designed to compare low-weight- molecular heparin (LMWH) to warfarin in reducing recurrent VTE among cancer patients. However, other outcomes were also evaluated, such as mortality and bleeding events observed more in cancer patients. The selection of relevant articles was carried out using a database search and a manual search, which involved reviewing reference lists of articles eligible for inclusion in the current review. The methodological quality of each included study was then assessed using Cochrane's risk of bias tool in the Review Manager software (RevMan 5.4.1). Additionally, pooled results were examined using the Review Manager software and presented as forest plots. Our search of electronic databases elicited a total of 2163 articles, of which only six were deemed eligible for inclusion and analysis. Data pooled from the six studies demonstrated the effectiveness of LMWH in minimizing the reoccurrence of VTE over warfarin [risk ratio (RR): 0.67; 95% CI: 0.47 - 0.95; p = 0.03]. However, LMWH had a similar effect statistically as warfarin on the major bleeding events (RR: 1.05; 95% CI: 0.62 - 1.77; p = 0.85), minor bleeding events (RR: 0.80; 95% CI: 0.54 - 1.20; p = 0.28), and all-cause mortality (RR: 1.00; 95% CI: 0.88 - 1.13; p = 0.99). While LMWH demonstrated its effectiveness in minimizing the incidence of VTE recurrence over warfarin in cancer patients, it had no statistical difference in terms of mortality or bleeding events when compared to warfarin. Based on our findings, we recommend that LMWH continues to be used as a first-line treatment regimen to mitigate recurrent VTE in cancer patients.

Indexed as

dalteparinenoxaparinlow-molecular weight heparinmalignancyrecurrent deep vein thrombosisrecurrent venous thromboembolismvitamin k antagonistswarfarin

Identifiers

PMID37533609
PMCPMC10390756
OpenAlexW4382813903

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.