ReviewJACC. Asia2023
Direct Oral Anticoagulant Dosing in Patients With Atrial Fibrillation: An Asian Perspective.
Review in JACC. Asia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Effectiveness and Safety of Dose-Specific DOACs in Patients With Atrial Fibrillation: A Systematic Review and Network Meta-Analysis.Cardiovascular therapeutics · 2025Pooled it
- Real-world evidence on off-label underdosing of direct oral anticoagulants in Asian patients with atrial fibrillation: prescribing patterns, determinants, and outcomes.Future science OA · 2026Article
- Anticoagulant adherence and associated complications and readmissions in older valve surgery adults: insights from a retrospective cohort study.BMC geriatrics · 2026Article
- Performance of DOAC and HAS-BLED scores in predicting major bleeding in Asian patients with non-valvular atrial fibrillation receiving direct oral anticoagulants.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Genetic liability to atrial fibrillation, aortic valve disease, and mitral valve disease: a two-sample Mendelian randomization study.World journal of emergency medicine · 2025Article
- Bleeding risk in East Asian patients with atrial fibrillation: Validation of the DOAC score in a Japanese multicenter registry.Heart rhythm O2 · 2025Article
- Evaluation of DOAC Dosing Among Various Renal Equations in Patients With Kidney Impairment and Elderly in Thailand.Clinical and translational science · 2025Article
- Strategies for the prevention of ischemic stroke in atrial fibrillation in East Asia: clinical features, changes and challenges.The Lancet regional health. Western Pacific · 2025Review
- A Membrane Modification Technique for Left Atrial Appendage Occlusion: A Multicenter Randomized Controlled Trial.JACC. Asia · 2025Article
- Increasing Very Low-Dose Edoxaban Prescription: Effectiveness and Safety Data of Korean AF Patients.Korean circulation journal · 2025Article
- Prevalence, risk characteristics, and prediction of low-dose edoxaban treatment in hospitalized patients: a multicenter, observational cohort study.Frontiers in pharmacology · 2025Article
- Association Between Direct Oral Anticoagulant Score and Bleeding Events in Patients With Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: A Retrospective Multicenter Cohort Study.Journal of the American Heart Association · 2024Article
- Underdosed Edoxaban and Clinical Outcomes in Patients with Non-valvular Atrial Fibrillation in Real World: A Retrospective Cohort Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 8 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Optimal dosing of direct oral anticoagulants (DOACs) for stroke prevention in "gray area" patients with atrial fibrillation (AF) remains a challenge for clinicians. In Asia, this is concerning in patients who are very elderly, have low body weight, and are at a high risk of bleeding. This review aims to summarize the dose reduction criteria for DOACs, discuss the evidence on dosing of DOACs across Asian regions, and collate opinions from authors across Asia. Nonrecommended dosing of DOACs is common in Asia, primarily due to the fear of bleeding, with the total clinical benefit of higher dosing being overlooked. The ELDERCARE-AF (Edoxaban Low-Dose for Elder Care-Atrial Fibrillation Patients) trial and real-world case studies provide some evidence on the use of low-dose DOACs in gray area patients. Opinions on dose adjustment guidance, concomitant medication adjustments, and therapeutic drug monitoring were collated. Research is needed to fill the evidence gaps on optimal DOAC doses for gray area patients.
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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.