SynthesisCurrent vascular pharmacology2025
Comparative Efficacy and Safety of Direct Oral Anticoagulants and Warfarin in Morbidly Obese Patients (BMI \>40 kg/m2): A Systematic Review and Meta-Analysis.
Synthesis in Current vascular pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Dabigatran outperforms warfarin in elderly patients with atrial fibrillation and stable coronary artery disease: reduced risks of bleeding and cardiovascular events.American journal of translational research · 2026Article
- Are the Direct Oral Anticoagulants Better Than Warfarin for the Prevention and Treatment of Stroke and Atrial Fibrillation?Handbook of experimental pharmacology · 2026Review
- The impact of body composition variability on coagulation monitoring in patients on direct oral factor Xa inhibitors for treatment of venous thromboembolism.Frontiers in cardiovascular medicine · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCurrent guidelines and consensus statements advise caution in using direct oral anticoagulants (DOACs) for morbidly obese patients with body mass index (BMI) >40 kg/m2, indicating warfarin as the most studied treatment.
methodsWe systematically searched databases from their inception to January 4, 2024, to identify studies that evaluated the effectiveness and safety of DOACs compared to warfarin in patients with BMI >40 kg/m
resultsThis meta-analysis included 24 studies and 119,960 morbidly obese patients with AF or VTE on oral anticoagulation therapy: 51,363 on DOACs (43%) vs. (57%) 68,597 on warfarin. DOAC use was significantly associated with lower all-cause mortality and major bleeding risk compared to warfarin. Although the risk of composite endpoint, stroke/SE, and VTE was lower in the DOAC group, no statistically significant difference was observed, indicating no superiority of warfarin compared to DOAC use. The risk of minor bleeding events, hemorrhagic stroke, and ischemic stroke was lower in the DOAC compared to the warfarin group. The same trend favoring DOACs over warfarin in all assessed endpoints was observed in the subgroup analysis based on anticoagulation indication (AF or VTE).
conclusionOur findings have documented a potentially more effective and safer profile of DOACs compared to warfarin in morbidly obese patients regardless of the indication for anticoagulation.
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