Evidence map›Paper›PMID 40985187›Full record

ArticleJournal of internal medicine2025

Oral anticoagulation in patients with gastrointestinal bleeding and new-onset atrial fibrillation: A population-based registry-linkage study.

Santeri Jolkkonen, Jukka Putaala, Konsta Teppo, Pirjo Mustonen, Jussi Jaakkola, Aapo Aro, Olli Halminen, Ossi Lehtonen, Jari Haukka, Miika Linna and 3 more

Abstract read
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In one paragraph

Article in Journal of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. 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

13 authors.

Santeri JolkkonenFaculty of Medicine, University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0002-4331-2616
Jukka PutaalaDepartment of Neurology, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Konsta TeppoHeart Center, Turku University Hospital and University of Turku, Turku, Finland.
Pirjo MustonenHeart Center, Turku University Hospital and University of Turku, Turku, Finland.
Jussi JaakkolaHeart Center, Turku University Hospital and University of Turku, Turku, Finland.
Aapo AroHeart and Lung Center, HUS Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Olli HalminenDepartment of Industrial Engineering and Management, Aalto University, Espoo, Finland.
Ossi LehtonenDepartment of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
Jari HaukkaDepartment of Public Health, Clinicum, University of Helsinki, Helsinki, Finland.
Miika LinnaDepartment of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
Juha HartikainenHeart Center, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
K E Juhani AiraksinenHeart Center, Turku University Hospital and University of Turku, Turku, Finland.
Mika LehtoFaculty of Medicine, University of Helsinki, Helsinki, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLimited data exist on the prevalence of gastrointestinal bleeding (GIB) in patients with new-onset atrial fibrillation (AF) and the impact of GIB on the initiation of oral anticoagulation (OAC) therapy.

methodsA population-based registry-linkage study included all patients diagnosed with new-onset AF in Finland during 2010-2018 who had available laboratory data and a definite indication for OAC therapy. The primary outcome was OAC initiation within 90 days following AF diagnosis. Factors associated with OAC initiation were assessed using modified Poisson regression.

resultsAmong 117 997 patients with new-onset AF, 6628 (5.6%) had GIB, of which 5336 occurred more than 30 days prior to AF diagnosis, and 1292 were temporally (±30 days) associated with new-onset AF (GIBTAF). Patients with GIB compared to those without GIB were older (mean age 78.3 vs. 75.3 years), more frequently men (48.5% vs. 41.9%), and had more comorbidities. The occurrence of GIB was associated with a lower probability of initiating OAC (RR 0.84, 95% CI 0.81-0.86). Among patients with GIB, an obscure origin of GIB (RR 0.93, 95% CI 0.88-0.99) or GIBTAF reduced the likelihood of OAC initiation (RR 0.72, 95% CI 0.66-0.79). The initiation of OAC did not depend on the known GIB bleeding site (lower vs. upper). Overall, the initiation of OAC therapy increased from 2010 to 2018 but remained consistently lower in patients with GIB.

conclusionPrior and concurrent GIB is common among patients with new-onset AF, and despite the overall increasing use of OACs, they remain less utilized in patients with GIB.

Indexed as

AnticoagulantsAtrial FibrillationGastrointestinal HemorrhageAdministration, OralAgedAged, 80 and overFemaleFinlandHumansMaleMiddle AgedRegistriesAnticoagulantsanticoagulantsatrial fibrillationgastrointestinal hemorrhageretrospective studies

Identifiers

PMID40985187
PMCPMC12522523

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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.