Observational studyANZ journal of surgery2025
Early use of non-vitamin K antagonist oral anticoagulants after cardiac surgery compared with warfarin for postoperative atrial fibrillation.
Observational study in ANZ journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 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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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.
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Who cites it
2 citing papers in PubMed.
- Direct Oral Anticoagulants Compared to Warfarin Early After Cardiac Surgery: A Pilot Randomized Controlled Trial.CJC open · 2026Article
- Does the type of oral anticoagulant matter for stroke prevention or bleeding in patients with atrial fibrillation after cardiac surgery? A systematic review and meta-analysis.European heart journal open · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe introduction of non-vitamin-K-antagonist oral anticoagulants (NOAC) has shifted the landscape of anticoagulation in the setting of atrial fibrillation (AF), as an alternative to warfarin. Despite extensive evidence for NOACs in non-perioperative and non-valvular AF, there remains little consensus on anticoagulation choice for patients with postoperative atrial fibrillation (POAF) after cardiac surgery.
methodsThis retrospective, observational study included 2263 patients who underwent cardiac surgery between 1 March 2016 and 13 January 2023 at a tertiary cardiac centre. Patients with pre-existing AF, valvular AF and transcatheter interventions were excluded. Short- and long-term outcomes were compared between patients who received a NOAC and those who received warfarin for POAF. A Cox regression model was constructed to identify independent predictors for time-to-mortality. Subgroup analysis was performed based on the type of surgery, including CABG-only, aortic valve replacement (AVR)-only, and combined surgery cohorts.
resultsOf the 2263 patients, 556 (24.5%) developed POAF. Of those who developed POAF, 162 were anticoagulated with warfarin and 65 were anticoagulated with a NOAC, including apixaban, rivaroxaban and dabigatran. There were three cases of permanent stroke in the warfarin group compared with no cases in the NOAC group. All-cause 30-day and one-year readmission rates were similar between groups. The use of NOAC or warfarin did not impact overall survival in the Kaplan-Meier analysis. Subgroup analysis demonstrated similar outcomes in CABG-only, AVR-only and combined surgery groups.
conclusionsWarfarin and NOAC performed similarly in short- and long-term complications, suggesting NOAC as a plausible alternative to warfarin for anticoagulation in POAF.
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