Evidence map›Paper›PMID 39153114›Full record

SynthesisCardiovascular drugs and therapy2025

Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants Compared with Vitamin K Antagonists in Patients with Atrial Fibrillation and Type 2 Valvular Heart Disease: A Systematic Review and Meta-Analysis.

Xiaoyun Liang, Shangyu Liu, Lishuang Ji, Fangfang Ma, Guoyuan Song, Fang Li, Gang Liu

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Cardiovascular drugs and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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. Article
  2. Review
  3. Anticoagulation in Atrial Fibrillation With Valvular Heart Disease.Journal of the American Heart Association · 2025
    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

7 authors.

Xiaoyun Liang *Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Shangyu Liu *Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Lishuang JiDepartment of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Fangfang MaDepartment of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Guoyuan SongDepartment of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Fang LiDepartment of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Gang LiuDepartment of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. cardio2004@hebmu.edu.cn.ORCID 0000-0003-1221-3698

Funding

Hebei Province Finance Department Project LS202214Industry-Academic Cooperation Foundation of Kyungnam University CXY2024020Industry University Research Cooperation Special Project CXY2024020Key Science and Technology Research Program of Hebei Provincial Health Commission 20230991Natural Science Foundation of Hebei Province H2022206295
6 · The paper itself

Abstract

purposeThis meta-analysis aimed to evaluate the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) compared with vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) and type 2 valvular heart disease (VHD).

methodsWe searched the PubMed, LILACS, and MEDLINE databases to retrieve, randomized controlled trials (RCTs) comparing NOACs and VKAs in patients with AF and type 2 VHD, excluding mitral stenosis (moderate to severe, of rheumatic origin) or mechanical heart valves. The efficacy outcomes assessed were stroke and systemic embolism (SE), while safety outcomes included major bleeding and intracranial hemorrhage (ICH).

resultsSeven RCTs, including 16,070 patients with AF and type 2 VHD, were included. NOACs reduced the risk of stroke/SE (relative risk [RR], 0.75; 95% confidence interval [CI], 0.64-0.89; P = 0.0005), with no significant difference in major bleeding (RR, 0.88; 95% CI, 0.64-1.21; P = 0.43). The risk of ICH was reduced with NOACs (RR, 0.46; 95% CI, 0.27-0.77; P = 0.003). For patients with AF and bioprosthetic heart valve (five trials, 2805 patients), stroke/SE risks (RR, 0.65, 95% CI, 0.44-0.96) with NOACs were superior to VKAs. Major bleeding risks without ENVISAGE TAVI AF trial (RR, 0.53; 95% CI, 0.30-0.94; P = 0.03) with NOACs were superior to VKAs. The risks of ICH (RR, 0.61; 95% CI 0.34-1.09; P = 0.09) with NOACs were comparable to VKAs.

conclusionsNOACs demonstrate efficacy and safety in patients with AF and type 2 VHD and reduce the risk of stroke/SE and ICH when compared with those with VKAs.

Indexed as

AnticoagulantsAtrial FibrillationHeart Valve DiseasesStrokeVitamin KAdministration, OralEmbolismHemorrhageHumansRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeAnticoagulantsVitamin KAnticoagulation therapyAtrial fibrillationNon-vitamin K antagonistOral anticoagulantsValvular heart diseaseVitamin K antagonists

Identifiers

PMID39153114
PMCPMC12717196

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.