Evidence map›Paper›PMID 40286370›Full record

ArticleJACC. Advances2025

A Comparison of Outcomes With Apixaban, Rivaroxaban, and Warfarin for Atrial Fibrillation and/or Venous Thromboembolism.

Jordan K Schaefer, Josh Errickson, Xiaowen Kong, Mona A Ali, Naina Chipalkatti, Brian Haymart, Scott Kaatz, Gregory D Krol, Suman L Sood, James B Froehlich and 1 more

Abstract read
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Comparing Efficacy and Safety of Different Anticoagulants in Cerebral Venous Thrombosis: A Systematic Review and Network Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  2. Review
  3. 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

11 authors.

Jordan K SchaeferDivision of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: jschaef@med.umich.edu.
Josh ErricksonConsulting for Statistics, Computing, & Analytics Research, University of Michigan, Ann Arbor, Michigan, USA.
Xiaowen KongDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Mona A AliDepartment of Heart and Vascular Services, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.
Naina ChipalkattiDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Brian HaymartDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Scott KaatzDivision of Hospital Medicine, Henry Ford Health, Detroit, Michigan, USA.
Gregory D KrolDepartment of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
Suman L SoodDivision of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
James B FroehlichDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Geoffrey D BarnesDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Funding

An Intervention to Reduce Cancer Associated Thrombosis Through Improved ProphylaxisK01HL169920 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jordan Schaefer · 2023 to 2026
$684k
NHLBI NIH HHS K01 HL169920
6 · The paper itself

Abstract

backgroundApixaban and rivaroxaban are commonly used direct oral anticoagulants for atrial fibrillation (AF) and venous thromboembolism (VTE). Both have been compared to warfarin, but there are insufficient comparative outcome data.

objectivesThe purpose of this study was to assess outcomes of apixaban, rivaroxaban, and warfarin.

methodsThis is a registry-based cohort study with data from 6 centers in Michigan, 2009 to 2023. Patients were adults with AF and/or VTE with at least 3 months of follow-up. Outcomes included rates of bleeding, thrombosis, healthcare utilization, and death.

resultsA total of 13,435 patients met the study inclusion criteria (average age 66.7 years, 58.0% on anticoagulation for AF, average follow-up 28.2 months). After matching, 2 groups of 3,527 patients on apixaban and warfarin were compared. Any bleeding was similar between groups, but major bleeding was less with apixaban. Thrombotic event rates were higher with apixaban. Mortality, rates of emergency room visits, and hospitalizations for bleeding were higher with warfarin. After matching, 1,395 patients on rivaroxaban were compared to 4,185 patients on warfarin. Any bleeding and major bleeding were higher with rivaroxaban. Thrombotic event rates were similar, aside from a higher rate of "other" thrombosis with rivaroxaban. After matching, 2 groups of 1,395 patients on apixaban and rivaroxaban were compared. Any bleeding, major bleeding, and mortality were higher with rivaroxaban. Thrombotic event rates were similar.

conclusionsFor patients with AF and/or VTE, we observed that bleeding was highest with rivaroxaban, followed by warfarin, and then apixaban. Rates of thrombosis were higher with apixaban than with warfarin, largely driven by "other" thrombotic events.

Indexed as

atrial fibrillationfactor Xa inhibitorshemorrhageoutcomes assessmentvenous thromboembolismwarfarin

Identifiers

PMID40286370
PMCPMC12235406

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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.