Evidence map›Paper›PMID 41152740›Full record

ArticleBMC cardiovascular disorders2025

Echocardiographic hemodynamics correlate with differences in DOAC-specific bleeding and stroke rates in non-valvular atrial fibrillation.

Michael P O'Shea, Ali Yusuf, Eiad Habib, Srekar Ravi, Suganya Arunachalam Karikalan, Chieh Ju Chao, Hasan Ashraf, Pradyumna Agasthi, Sam Newton, Robert L Scott and 4 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
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Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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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.

Michael P O'SheaMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA. osheam12@tcd.ie.
Ali YusufMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Eiad HabibMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Srekar RaviMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Suganya Arunachalam KarikalanMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Chieh Ju ChaoMayo Clinic, Rochester, MN, USA.
Hasan AshrafChristus Good Shepherd Heart and Vascular Institute, Longview, TX, USA.
Pradyumna AgasthiSanford Health, University of North Dakota, Sanford, Florida, USA.
Sam NewtonLondon School of Hygiene and Tropical Medicine, London, England.
Robert L ScottMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Timothy BarryMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Chadi AyoubMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Reza ArsanjaniMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.
Hicham El MasryMayo Clinic, 134000 E Shea Blvd, Scottsdale, AZ, 85259, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsDirect oral anticoagulants (DOACs) are widely used for stroke prevention in people with non-valvular atrial fibrillation/flutter (NVAF).Anticoagulants have different bleeding profiles. Apixaban is associated with the lowest bleeding risk. This study evaluates the interaction between DOAC use and right ventricular systolic pressure (RVSP) on echocardiogram and bleeding rates. It was hypothesized that elevated RVSP may be associated with excess bleeding based on anticoagulant-specific pharmacologic profiles. METHODS&

resultsA retrospective analysis of a database was conducted. Multivariable regression models for bleeding rates were developed using an analysis approach that adjusts for confounders among participants who had undergone an echocardiogram, and interaction terms for DOAC choice were incorporated. Stratum-specific estimates were calculated using linear computation. Patients taking apixaban had lower bleeding rates than those taking rivaroxaban and dabigatran. Among those without elevated RVSP, there was no difference in bleeding rates. Where RVSP was ≥45mmHg, there was a 90% increase in bleeding rates with use of dabigatran (HR 1.99, p=0.024) and rivaroxaban (HR 1.86, p=0.042) compared to apixaban (Table 1D).

conclusionsElevated RVSP is associated with excess bleeding in patients taking rivaroxaban and dabigatran, but not apixaban, after controlling for confounding variables.

Indexed as

Atrial FibrillationDabigatranEchocardiographyFactor Xa InhibitorsHemodynamicsHemorrhagePyrazolesPyridonesRivaroxabanStrokeVentricular Function, RightAdministration, OralAgedAged, 80 and overDatabases, FactualFemaleapixabanDabigatranFactor Xa InhibitorsPyrazolesPyridonesRivaroxabanAnticoagulationApixabanAtrial FibrillationBleedingDabigatranDOACPulmonary HypertensionRight ventricular systolic pressureRivaroxaban

Identifiers

PMID41152740
PMCPMC12570840

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