Evidence map›Paper›PMID 40486638›Full record

ReviewAnnals of medicine and surgery (2012)2025

Anticoagulation strategies for stroke prevention in atrial fibrillation: a comprehensive review of current literature.

Zainab Aslam Castro-Vidal, Asad Gandapur, Rohit Prakash, Khaled Azab, Khushi Nayyar, Fnu Rinkoo, Sravani Kommuru, Youssef Elsoussi, Nagavenakta Lova Surya Vamsi Avinash Bojanki, Anil Kumar Yennam and 2 more

Abstract readReview
In one paragraph

Review in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Early versus late anticoagulation treatment after acute ischemic stroke with atrial fibrillation: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Pooled it
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

12 authors.

Zainab Aslam Castro-VidalDepartment of Surgery, Saba University School of Medicine, The Bottom, Saba.
Asad GandapurDepartment of Internal Medicine - Pulmonary, Critical Care and Sleep Medicine Division, University of Nebraska Medical Center, Omaha, Nebraska.ORCID https://orcid.org/0009-0009-1075-2429
Rohit PrakashDepartment of Oncology, South Tees Hospitals NHS Foundation Trust, Middlesbrough, North Yorkshire, UK.ORCID https://orcid.org/0009-0001-5761-0163
Khaled AzabDepartment of Internal Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.ORCID https://orcid.org/0009-0002-9701-4961
Khushi NayyarDepartment of Internal Medicine, Adesh Institute of Medical Sciences and Research, Bathinda, India.ORCID https://orcid.org/0009-0002-5069-9895
Fnu RinkooDepartment of Internal Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan.ORCID https://orcid.org/0009-0001-0668-4218
Sravani KommuruDr Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Andhra Pradesh, India.ORCID https://orcid.org/0009-0003-8936-8273
Youssef ElsoussiDepartment of Surgery, University of Sharjah, Sharjah, United Arab Emirates.ORCID https://orcid.org/0009-0007-8801-7120
Nagavenakta Lova Surya Vamsi Avinash BojankiDepartment of General Medicine, Siddhartha Medical College, Andhra Pradesh, India.
Anil Kumar YennamDepartment of Internal Medicine, Emilio Aguinaldo College, Manila, Philippines.
Syeed Mahmud NishatDepartment of Internal Medicine, Shaheed Suhrawardy Medical College, Dhaka, Bangladesh.
Jatin MotwaniDepartment of Internal Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan.ORCID https://orcid.org/0000-0001-7281-6453

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atrial fibrillation (AF) significantly increases stroke risk and hence requires anticoagulation for the prevention of stroke. This review discusses strategies of anticoagulation, including the paradigm shift from traditional vitamin K antagonists (VKAs), such as warfarin, to direct oral anticoagulants (DOACs): dabigatran, rivaroxaban, apixaban, and edoxaban. VKAs are effective but require regular monitoring of international normalized ratio and also pose challenges because of their drug and dietary interactions. In contrast, DOACs provide predictable pharmacokinetics, fewer interactions, and no requirement for routine monitoring, and their use is increasingly favored in clinical practice. The review puts an emphasis on the considerations that are patient-specific when choosing an anticoagulant agent, including age, renal function, and associated diseases; stroke risk or risk factors for bleeding; and it explains how tools such as the use of CHA2DS2-VASc and HAS-BLED scores can be relevant for assessing stroke and bleeding risk, respectively. Also, it is explored that the use of emerging therapies like factor XI inhibitors and combinations such as dual antiplatelet therapy with anticoagulants has the potential to provide maximum stroke prevention but fewer bleeding complications. This review evaluated the effect of reversal agents for anticoagulants that may act as a safety measure during instances of serious bleeding. In summary, AF anticoagulation has to be individually tailored based on patient characteristics and meticulous reading of clinical guidelines. As much as DOACs present a tremendous step forward in stroke prevention related to AF, future studies and emerging treatments show promise to further optimize therapeutic outcomes.

Indexed as

anticoagulation therapyatrial fibrillationdirect oral anticoagulants (DOACs)stroke preventionwarfarin

Identifiers

PMID40486638
PMCPMC12140764

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.