Evidence map›Paper›PMID 38429057›Full record

Observational studyOpen heart2024

Major bleeding in patients with atrial fibrillation treated with apixaban versus warfarin in combination with amiodarone: nationwide cohort study.

Astrid Fritz Hansson, Angelo Modica, Henrik Renlund, Christina Christersson, Claes Held, Gorav Batra

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 27% 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, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Observational
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 2 institutions in 1 country.

Astrid Fritz HanssonDepartment of Medical Sciences Cardiology, Uppsala University, Uppsala, Sweden.
Angelo ModicaPfizer AB, Stockholm, Sweden.
Henrik RenlundUppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Christina ChristerssonDepartment of Medical Sciences Cardiology, Uppsala University, Uppsala, Sweden.
Claes HeldUppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Gorav BatraDepartment of Medical Sciences Cardiology, Uppsala University, Uppsala, Sweden gorav.batra@ucr.uu.se.ORCID 0000-0002-2480-9547
Uppsala University · SEPfizer (Sweden) · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAmiodarone is an established treatment for atrial fibrillation (AF) but might interfere with the metabolism of apixaban or warfarin. Therefore, the aim was to investigate the occurrence of major bleeding among patients with AF treated with amiodarone in combination with apixaban or warfarin.

methodsRetrospective observational study using Swedish health registers. All patients with AF in the National Patient Register and the National Dispensed Drug Register with concomitant use of amiodarone and warfarin or apixaban between 1 June 2013 and 31 December 2018 were included. Propensity score matching was performed, and matched cohorts were compared using Cox proportional HRs. The primary outcome was major bleeding resulting in hospitalisation based on International Classification of Diseases (ICD)-10 codes. Secondary outcomes included intracranial bleeding, gastrointestinal bleeding and other bleeding. Exploratory outcomes included ischaemic stroke/systemic embolism and all-cause/cardiovascular (CV) mortality.

resultsA total of 12 103 patients met the inclusion criteria and 8686 patients were included after propensity score matching. Rates of major bleeding were similar in the apixaban (4.3/100 patient-years) and warfarin cohort (4.5/100 patient-years) (HR: 1.03; 95% CI: 0.76 to 1.39) during median follow-up of 4.4 months. Similar findings were observed for secondary outcomes including gastrointestinal bleeding and other bleeding, and exploratory outcomes including ischaemic stroke/systemic embolism and all-cause/CV mortality.

conclusionsAmong patients treated with amiodarone in combination with apixaban or warfarin, major bleeding and thromboembolic events were rare and with no significant difference between the treatment groups. EUPAS REGISTRY NUMBER: EUPAS43681.

Indexed as

AmiodaroneAtrial FibrillationBrain IschemiaEmbolismIschemic StrokePyrazolesPyridonesStrokeAnticoagulantsCohort StudiesGastrointestinal HemorrhageHumansWarfarinAmiodaroneAnticoagulantsapixabanPyrazolesPyridonesWarfarinatrial fibrillationepidemiologypharmacology, clinical

Identifiers

PMID38429057
PMCPMC10910422
OpenAlexW4392360201

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.