Evidence map›Paper›PMID 38650729›Full record

ArticleHealth science reports2024

Safety and efficacy of direct oral anticoagulants in comparison to warfarin in obese patients with atrial fibrillation: A systematic review and meta-analysis.

Alla Adelkhanova, Prakash Raj Oli, Dhan Bahadur Shrestha, Jurgen Shtembari, Vivek Jha, Ghanshyam Shantha, George Michael Bodziock, Monodeep Biswas, Muhammad Omer Zaman, Nimesh K Patel

Open access · goldAbstract read
In one paragraph

Article in Health science reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% 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, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
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 at 5 institutions in 1 country.

Alla AdelkhanovaDepartment of Internal Medicine Mount Sinai Hospital Chicago Illinois USA.
Prakash Raj OliDepartment of Internal Medicine Province Hospital Birendranagar Nepal.
Dhan Bahadur ShresthaDepartment of Internal Medicine Mount Sinai Hospital Chicago Illinois USA.ORCID 0000-0002-8121-083X
Jurgen ShtembariDepartment of Internal Medicine Mount Sinai Hospital Chicago Illinois USA.
Vivek JhaDepartment of Internal Medicine John H. Stroger, Jr. Hospital of Cook County Chicago Illinois USA.
Ghanshyam ShanthaDepartment of Internal Medicine, Division of Cardiac Electrophysiology Wake Forest University School of Medicine Winston Salem North Carolina USA.
George Michael BodziockDepartment of Internal Medicine, Division of Cardiac Electrophysiology Wake Forest University School of Medicine Winston Salem North Carolina USA.
Monodeep BiswasDepartment of Internal Medicine, Division of Cardiac Electrophysiology University of Maryland Medical Center Baltimore Maryland USA.
Muhammad Omer ZamanDepartment of Internal Medicine, Division of Cardiology Rudd Heart Hospital Louisville Kentucky USA.
Nimesh K PatelDepartment of Cardiology Bon Secours Richmond Virginia USA.
Mount Sinai Hospital · USWake Forest University · USBon Secours Liver Institute of Richmond · USJohn H. Stroger, Jr. Hospital of Cook County · USUniversity of Maryland, Baltimore · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aim: Obesity affects nearly 650 million adults worldwide, and the prevalence is steadily rising. This condition has significant adverse effects on cardiovascular health, increasing the risk of hypertension, coronary artery disease, heart failure, and atrial fibrillation (AF). While anticoagulation for obese patients with AF is a well-established therapy for the prevention of thromboembolism, the safety and efficacy of different anticoagulants in this specific population are not well explored. This meta-analysis aimed to compare direct oral anticoagulants (DOAC) to vitamin K antagonists in obese populations with AF. Methods: The PRISMA guidelines were followed for this meta-analysis, registered in PROSPERO (CRD42023392711). PubMed, PubMed Central, Embase, Cochrane Library, and Scopus databases were searched for relevant articles from inception through January 2023. Two independent authors screened titles and abstracts, followed by a full-text review in Covidence. Data were extracted in Microsoft Excel and analyzed using RevMan v5.4 using odds ratio as an effect measure. Results: Two thousand two hundred fifty-nine studies were identified from the database search, and 18 were included in the analysis. There were statistically significant reductions in the odds of ischemic and hemorrhagic stroke in the DOAC group compared with the VKA group (OR 0.70, CI 0.66-0.75) and (OR 0.47, CI 0.35-0.62), respectively. In addition, the DOAC group exhibited lower odds of systemic embolism (OR 0.67, CI 0.54-0.83), major bleeding (OR 0.62, CI 0.54-0.72), and composite outcome (OR 0.72, CI 0.63-0.81). Conclusion: Based on the findings from this meta-analysis, DOACs demonstrate superior safety and efficacy in obese patients with AF compared with VKAs. These results may have significant implications for guiding anticoagulation strategies in this patient population.

Indexed as

anticoagulationapixabanatrial fibrillationedoxabanobesityrivaroxaban

Identifiers

PMID38650729
PMCPMC11033493
OpenAlexW4395006503

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.