Evidence map›Paper›PMID 38153665›Full record

SynthesisInternational urology and nephrology2024

Direct oral anticoagulants versus vitamin K antagonists in patients with atrial fibrillation on chronic hemodialysis: a meta-analysis of randomized controlled trials.

Denilsa D P Navalha, Nicole Felix, Alleh Nogueira, Mariana Clemente, Alice D Marinho, Rafael Oliva Morgado Ferreira, Eric Pasqualotto, Caroline Serafim Dagostin, Luis Cláudio Santos Pinto, Gilson C Fernandes

Abstract readMeta-AnalysisComparative StudySystematic Review
PubMed Publisher
In one paragraph

Synthesis in International urology and nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Treatment strategies of the thromboembolic risk in kidney failure patients with atrial fibrillation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 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

10 authors.

Denilsa D P NavalhaEduardo Mondlane University, Maputo, Mozambique.ORCID http://orcid.org/0009-0002-4805-0931
Nicole FelixFederal University of Campina Grande, Campina Grande, Brazil.ORCID http://orcid.org/0000-0001-8174-3866
Alleh NogueiraBahiana School of Medicine and Public Health, Salvador, Brazil.ORCID http://orcid.org/0000-0001-5995-6179
Mariana ClementePetrópolis School of Medicine, Petrópolis, Brazil.ORCID http://orcid.org/0009-0005-5842-9007
Alice D MarinhoFederal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0002-3838-5765
Rafael Oliva Morgado FerreiraFederal University of Santa Catarina, Florianópolis, Brazil.ORCID http://orcid.org/0000-0002-3203-0509
Eric PasqualottoFederal University of Santa Catarina, Florianópolis, Brazil.ORCID http://orcid.org/0000-0002-6484-1162
Caroline Serafim DagostinUniversity of the Extreme South of Santa Catarina, Santa Catarina, Brazil.ORCID http://orcid.org/0000-0002-5047-4023
Luis Cláudio Santos PintoMetropolitan University Center of Amazonia, Belém, Brazil.ORCID http://orcid.org/0000-0002-8039-4075
Gilson C FernandesBoston University, 830 Harrison Ave, Boston, MA, USA. gilsonmcff@gmail.com.ORCID http://orcid.org/0000-0001-5847-0708

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients with atrial fibrillation (AF) and end-stage renal disease on chronic hemodialysis are at risk for thromboembolic and bleeding events. We aimed to perform a meta-analysis to evaluate the safety and efficacy of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKAs) in this population.

methodsWe systematically searched PubMed, Excerpta Medica Database (EMBASE) and Cochrane Library for randomized controlled trials (RCTs) comparing DOACs with VKAs in patients with AF on chronic hemodialysis from inception to February 2023 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Outcomes were reported using risk ratios (RRs) with 95% confidence intervals (CIs). Statistical analyses were performed using R version 4.2.2.

resultsWe selected three RCTs including 341 patients, of whom 176 (51.6%) were randomized to DOACs. Follow-up ranged from 174 days to 3.38 years. There was no significant difference between groups in terms of cardiovascular mortality (RR 1.34; 95% CI 0.69-2.60; p = 0.39), all-cause mortality (RR 0.96; 95% CI 0.72-1.27; p = 0.77), ischemic/uncertain type of stroke or transient ischemic attack (RR 0.50; 95% CI 0.19-1.35; p = 0.17), or major or life-threatening bleeding (RR 0.70; 95% CI 0.39-1.25; p = 0.22).

conclusionIn this meta-analysis of three RCTs, no significant difference was observed between DOACs and VKAs in cardiovascular mortality, all-cause mortality, ischemic/uncertain type of stroke or transient ischemic attack, or major or life-threatening bleeding in patients with AF on chronic hemodialysis.

Indexed as

AnticoagulantsAtrial FibrillationRandomized Controlled Trials as TopicRenal DialysisVitamin KAdministration, OralHumansKidney Failure, ChronicAnticoagulantsVitamin KAnticoagulationAtrial fibrillationDirect oral anticoagulantsEnd-stage renal diseaseHemodialysisVitamin-K antagonists

Identifiers

PMID38153665

What OpenQuestion holds

Textmetadata
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.