Evidence map›Paper›PMID 38281231›Full record

SynthesisJournal of thrombosis and thrombolysis2024

Direct oral anticoagulants versus vitamin K antagonists in patients with atrial fibrillation and stage 5 chronic kidney disease under dialysis: A systematic review and meta-analysis of randomized controlled trials.

Larissa A de Lucena, Marcos A A Freitas, Ana K C Souza, Caroliny H A Silva, Janine M F Watanabe, Felipe L Guedes, Jose B Almeida, Rodrigo A de Oliveira

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of thrombosis and thrombolysis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 8% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Factor Xa Inhibitors Versus Vitamin K Antagonists in Atrial Fibrillation Patients with End-Stage Kidney Disease on Dialysis: A Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  3. Review
  4. Observational
  5. 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

8 authors at 4 institutions in 1 country.

Larissa A de LucenaDepartment of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil.
Marcos A A FreitasDepartment of Medicine, State University of Região Tocantina do Maranhão, Department of Medicine, Imperatriz, Brazil.
Ana K C SouzaDepartment of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil.
Caroliny H A SilvaDepartment of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil.
Janine M F WatanabeDepartment of Medicine, State University of Piauí, Teresina, Brazil.
Felipe L GuedesDivision of Nephrology, University Hospital Onofre Lopes, Natal, Brazil.
Jose B AlmeidaDepartment of Integrated Medicine, Federal University of Rio Grande do Norte, Nilo Peçanha Avenue, 620, 3rd underground - Petroópolis, Natal, 59012-300, Brazil.
Rodrigo A de OliveiraDepartment of Integrated Medicine, Federal University of Rio Grande do Norte, Nilo Peçanha Avenue, 620, 3rd underground - Petroópolis, Natal, 59012-300, Brazil. razoliveira@gmail.com.ORCID http://orcid.org/0000-0003-1617-6759
Universidade Federal do Rio Grande do Norte · BRHospital Universitário Onofre Lopes · BRUniversidade Estadual da Região Tocantina do Maranhão · BRUniversidade Estadual do Piauí · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with atrial fibrillation (AF) and normal or slightly impaired renal function, the use of direct oral anticoagulants (DOACs) is preferable to vitamin K antagonists (VKAs). However, in patients undergoing hemodialysis, the efficacy, and safety of DOACs compared with VKAs are still unknown. PURPOSE: To review current evidence about the safety and efficacy of DOACs compared to VKAs, in patients with AF and chronic kidney disease under hemodialysis.

methodsWe systematically searched PubMed, Scopus, and Cochrane databases for RCTs comparing DOACs with VKAs for anticoagulation in patients with AF on dialysis therapy. Outcomes of interest were: (1) stroke; (2) major bleeding; (3) cardiovascular mortality; and (4) all-cause mortality. Statistical analysis was performed using RevMan 5.1.7 and heterogeneity was assessed by I

resultsThree randomized controlled trials were included, comprising a total of 383 patients. Of these, 218 received DOACs (130 received apixaban; 88 received rivaroxaban), and 165 were treated with VKAs (116 received warfarin; 49 received phenprocoumon). The incidence of stroke was significantly lower in patients treated with DOACs (4.7%) compared with those using VKAs (9.5%) (RR 0.42; 95% CI 0.18-0.97; p = 0.04; I

conclusionThis meta-analysis suggests that in patients with AF on dialysis, the use of DOACs was associated with a significant reduction in stroke, and a numerical trend of less incidence of major bleeding compared with VKAs, but in this case with no statistical significance. Results may be limited by a small sample size or insufficient statistical power.

Indexed as

Atrial FibrillationKidney Failure, ChronicStrokeAdministration, OralAnticoagulantsFibrinolytic AgentsHemorrhageHumansRandomized Controlled Trials as TopicRenal DialysisVitamin KAnticoagulantsFibrinolytic AgentsVitamin KAtrial fibrillationChronic kidney diseaseDirect oral anticoagulantsHemodialysisVitamin K antagonists

Identifiers

PMID38281231
OpenAlexW4391291226

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.