Evidence map›Paper›PMID 41262181›Full record

ReviewAmerican heart journal plus : cardiology research and practice2025

Direct oral anticoagulants versus low-molecular-weight heparin for thromboprophylaxis in cancer-related surgeries: A meta-analysis of efficacy and safety outcomes.

Asma Mousavi, Shayan Shojaei, Parham Dastjerdi, Soheil Rahmati, Kasra Izadpanahi, Homayoun Pishraft-Sabet, Elmira Jafari Afshar, Keyvan Salehi, Mahshad Sabri, Mahsa Noohi Arbatan and 6 more

Abstract readReview
In one paragraph

Review in American heart journal plus : cardiology research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

16 authors.

Asma MousaviTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Shayan ShojaeiTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Parham DastjerdiTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Soheil RahmatiTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Kasra IzadpanahiTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Homayoun Pishraft-SabetTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Elmira Jafari AfsharCardiovascular Research Center, Alborz University of Medical Sciences, Alborz, Iran.
Keyvan SalehiTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Mahshad SabriRajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Mahsa Noohi ArbatanSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Parisa FallahtaftiTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Aronow WilbertWestchester Medical Center, Cardiology Division, New York Medical College, Valhalla, New York, United States.
Andrew P AmbrosyKaiser Permanente, San Francisco Medical Centre and Medical Offices, San Francisco, United States.
Mushabbar A SyedLoyola University Stritch School of Medicine, Chicago, United States.
Mina IskanderHeart and Vascular Center, Center of Advanced Care, Froedtert Hospital, WI, United States.
Kaveh HosseiniTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Post-operative venous thromboembolism (VTE) remains a concern following cancer-related surgeries. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of direct oral anticoagulants (DOACs) compared to low molecular weight heparin (LMWH) for thromboprophylaxis after cancer-related surgeries. Methods: We systematically searched databases for studies comparing DOACs to LMWH for post-operative thromboprophylaxis in patients undergoing cancer-related surgeries. Primary outcomes were VTE incidence and bleeding events. Secondary outcomes included all-cause mortality and hospitalization rates. Subgroup analyses examined DOAC type, cancer type, and follow-up duration. A random-effects model calculated pooled risk ratios (RRs) with 95 % confidence intervals (CIs). Results: Analysis included 16 studies with 6400 participants in the DOAC group (mean age 62.05 years, 28.15 % male) and 5801 participants in the LMWH group (mean age 60.78 years, 34.65 % male). DOACs were non-inferior to LMWH for VTE prevention (RR = 0.81, 95 % CI 0.56 to 1.16) with no significant difference in bleeding rates (RR = 0.70, 95 % CI 0.70 to 1.18). Mortality and hospitalization rates were similar between groups. Subgroup analyses suggested possible VTE reduction with DOACs in urological cancer surgeries (RR = 0.52, 95 % CI 0.44 to 0.61) and lower bleeding trends with Apixaban (RR = 0.64, 95 % CI 0.44 to 0.94). Conclusions: DOACs appear non-inferior to LMWH for post-operative thromboprophylaxis in patients undergoing cancer-related surgeries, with comparable safety. The superior VTE prevention in urological cancer surgeries and Apixaban's favorable safety profile warrant further investigation. Moreover, additional research is necessary to clarify the roles of specific DOACs and optimal prophylaxis strategies across various cancer types and surgical procedures.

Indexed as

Cancer-related surgeriesDOACsLMWHmeta-analysisThromboprophylaxis

Identifiers

PMID41262181
PMCPMC12624218

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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.