ReviewJournal of clinical medicine2023
DOACs in the Anticoagulation of Mechanical Valves: A Systematic Review and Future Perspectives.
Review in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis 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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Expanding indications for transcatheter aortic valve implantation: time for valve-in-valve in mechanical prosthesis? A systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- A comprehensive multicenter study assessing the impact of abelacimab, asundexian, and milvexian on coagulation assays.Blood advances · 2026Article
- A qualitative study of warfarin self-management in the United States healthcare system: insights from patient experiences.Journal of thrombosis and thrombolysis · 2026Article
- Cost-Effectiveness Analysis of Patient Self-Management of Warfarin Among Patients With Non-Valvular Atrial Fibrillation.Pharmacotherapy · 2026Article
- Adherence to Treatment, Quality of Life, and Level of Knowledge in Patients on Anticoagulant Therapy with Vitamin K Antagonists.Healthcare (Basel, Switzerland) · 2026Article
- Direct Carotid Artery Exposure for Mechanical Thrombectomy in a Patient with Marfan Syndrome and Prior Total Arch Replacement.NMC case report journal · 2026Article
- Warfarin-induced skin necrosis: a narrative review of clinical features, risk factors, and treatment strategies.Annals of medicine and surgery (2012) · 2025Review
- Prosthetic Heart Valves: More than Half a Century of Innovation-An Overview.Journal of clinical medicine · 2025Review
- Intrinsic pathway activation in patients with antiphospholipid syndrome and healthy controls.Research and practice in thrombosis and haemostasis · 2025Article
- Novel horizons in anticoagulation: the emerging role of factor XI inhibitors across different settings.Haematologica · 2024Review
- Management and 1-Year Outcome in Elderly Patients with Hip Fracture Surgery Receiving Anticoagulation (Warfarin or DOAc) or P2Y12 Antiplatelet Agents.Journal of clinical medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Valvular heart disease is a common disease often necessitating valve replacement. Mechanical heart valves (MHVs) are often used in younger patients because of their longer durability. Their main disadvantage is the need for lifelong anticoagulation. Warfarin is considered a standard treatment, but it is far from perfect. Direct oral anticoagulants (DOACs) are a new and more patient-friendly alternative to warfarin when anticoagulation is required, but have not yet been approved for the indication of mechanical valves. EVIDENCE ACQUISITION: A literature search of Pubmed, Embase, Web of Science (Core Collection), and Cochrane Library (from inception to May 2023) was performed using a search string that was well defined and not modified during the study. An extensive overview of the search terms used in each database can be found in the Appendix. Only prospective clinical trials were included in this review. A total of 10 publications were included in this review. RELEVANCE TO CLINICAL PRACTICE: This systematic review summarizes the different types of DOACs and their possible use in the anticoagulation of mechanical valves. We aim to propose future directions in anticoagulation research for mechanical valves.
conclusionsDOAC use in MHVs has been halted due to the failure of both dabigatran and apixaban in two major clinical trials. However, rivaroxaban was successful in two small clinical trials. Ample research is still needed to explore new valve designs as well as new anticoagulation targets.
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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.