Evidence map›Paper›PMID 37978999›Full record

ArticleEuropean journal of clinical pharmacology2024

Direct oral anticoagulants and the risk of adverse clinical outcomes among patients with different body weight categories: a large hospital-based study.

Ezekwesiri Michael Nwanosike, Hamid A Merchant, Wendy Sunter, Muhammad Ayub Ansari, Barbara R Conway, Syed Shahzad Hasan

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of clinical pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 26% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. 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

6 authors at 3 institutions in 1 country.

Ezekwesiri Michael NwanosikeDepartment of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
Hamid A MerchantDepartment for Bioscience, School of Health, Sport and Bioscience, the University of East London, London, E16 2RD, UK.
Wendy SunterCalderdale and Huddersfield Pharmacy Services, Anticoagulation Services, Calderdale and Huddersfield NHS Foundation Trust Hospitals, Lindley, Huddersfield, HD3 3EA, UK.
Muhammad Ayub AnsariSchool of Computing and Engineering, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
Barbara R ConwayDepartment of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
Syed Shahzad HasanDepartment of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK. s.hasan@hud.ac.uk.
University of Huddersfield · GBCalderdale and Huddersfield NHS Foundation Trust · GBUniversity of East London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThrough predictable pharmacokinetics-including a convenient fixed-dose regimen, direct oral anticoagulants (DOACs) are preferred over previous treatments in anticoagulation for various indications. However, the association between higher body weight and the risk of adverse consequences is not well studied among DOAC users. We aim to explore the association of body weight and adverse clinical outcomes in DOAC users.

methodsA total of 97,413 anonymised DOAC users in a tertiary care setting were identified following structured queries on the electronic health records (EHRs) to extract the feature-rich anonymised dataset. The prepared dataset was analysed, and the features identified with machine learning (ML) informed the adjustments of covariates in the multivariate regression analysis to examine the association. Kaplan-Meier analysis was performed to evaluate the mortality benefits of DOACs.

resultsAmong DOAC users, the odds of adverse clinical outcomes, such as clinically relevant non-major bleeding (CRNMB), ischaemic stroke, all-cause mortality, and prolonged hospital stay, were lower in patients with overweight, obesity, or morbid obesity than in patients with normal body weight. The odds of ischaemic stroke (OR 0.42, 95% CI: 0.36-0.88, p = 0.001) and all-cause mortality (OR 0.87, 95% CI: 0.81-0.95, p = 0.001) were lower in patients with morbid obesity than in patients with normal body weight. In the Kaplan-Meier analysis, apixaban was associated with a significantly lower rate of mortality overall and in obesity and overweight subgroups than other DOACs (p < 0.001). However, rivaroxaban performed better than apixaban in the morbid obesity subgroup (p < 0.001).

conclusionThis study shows the positive effects of DOAC therapy on clinical outcomes, particularly in patients with high body weight. However, this still needs validation by further studies particularly among patients with morbid obesity.

Indexed as

Atrial FibrillationBrain IschemiaIschemic StrokeObesity, MorbidStrokeAdministration, OralAnticoagulantsDabigatranHospitalsHumansOverweightRetrospective StudiesRivaroxabanWarfarinAnticoagulantsDabigatranRivaroxabanWarfarinDirect oral anticoagulantsElectronic health recordsEnglandMachine learningMortalityObesity

Identifiers

PMID37978999
PMCPMC10781787
OpenAlexW4388797397

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.