Evidence map›Paper›PMID 40620744›Full record

ReviewArchives of medical sciences. Atherosclerotic diseases2025

Efficacy and safety of direct oral anticoagulants versus warfarin in patients with atrial fibrillation and liver disease: an updated systematic review and meta-analysis.

Riya Bhagwan, Rushaan Ahmed, Saad Ahmed Idrees, Saad Javaid, Roha Mazhar, Rahima Tauqeer, Mushood Ahmed, Satesh Kumar, Mahima Khatri, Ashish Gupta and 4 more

Abstract readReview
In one paragraph

Review in Archives of medical sciences. Atherosclerotic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Riya BhagwanDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Rushaan AhmedDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Saad Ahmed IdreesDepartment of Medicine, Khyber Medical College, Peshawar, Pakistan.
Saad JavaidDepartment of Medicine, Lahore Medical and Dental College, Lahore, Pakistan.
Roha MazharDepartment of Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
Rahima TauqeerDepartment of Medicine, Akhtar Saeed Medical and Dental College, Lahore, Pakistan.
Mushood AhmedRawalpindi Medical University, Pakistan.
Satesh KumarShaheed Mohtarma Benazir Bhutto Medical College, Karachi, Pakistan.
Mahima KhatriDepartment of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Ashish GuptaSunderland Royal Hospital, UK.
Ramachandra RamkumarSunderland Royal Hospital, UK.
Mudassar BaigSunderland Royal Hospital, UK.
Peter CollinsImperial College London, UK.
Raheel AhmedImperial College London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Although previous meta-analyses have explored the efficacy and safety of direct oral anticoagulants (DOAC) compared to warfarin in patients with atrial fibrillation (AFib) and liver disease, recent studies and emerging data necessitate a re-evaluation of the topic. Therefore, we conducted an updated meta-analysis to incorporate the latest evidence and provide a more comprehensive understanding of the literature. This meta-analysis aimed to assess the safety and efficacy of DOAC in patients diagnosed with AFib and liver disease. Methods: Following PRISMA guidelines, this meta-analysis is registered with PROSPERO (2024 CRD42024584964). A detailed search up to August 2024 was conducted for the studies comparing DOAC with warfarin. The quality of the included observational studies was evaluated using the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool. Results: This meta-analysis included 53,224 participants with AFib and liver disease. The use of DOAC, in comparison to warfarin, was significantly linked to a lower risk of all-cause mortality (HR = 0.77; 95% CI: 0.60-0.98; Conclusions: Recent studies indicate that DOAC are at least non-inferior to warfarin concerning efficacy and safety of patients with AFib and liver disease.

Indexed as

atrial fibrillationdirect oral anticoagulantsliver diseasesafety and efficacywarfarin

Identifiers

PMID40620744
PMCPMC12223980

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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.