Evidence map›Paper›PMID 41380911›Full record

SynthesisIndian heart journal

Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: A network meta-analysis of randomized trials.

Manyata Srivastava, Annu Gulia, Kamalesh Kumar Patel, Ashish Datt Upadhyay, Deepti Vibha, Pradeep Kumar

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Indian heart journal. 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

6 authors.

Manyata SrivastavaClinical Research Unit, All India Institute of Medical Sciences, New Delhi, India. Electronic address: manyata.sri20@gmail.com.
Annu GuliaClinical Research Unit, All India Institute of Medical Sciences, New Delhi, India. Electronic address: annugulia664@gmail.com.
Kamalesh Kumar PatelClinical Research Unit, All India Institute of Medical Sciences, New Delhi, India. Electronic address: kamaleshpatel@aiims.edu.
Ashish Datt UpadhyayClinical Research Unit, All India Institute of Medical Sciences, New Delhi, India. Electronic address: aduaiims@gmail.com.
Deepti VibhaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: deeptivibha@gmail.com.
Pradeep KumarClinical Research Unit, All India Institute of Medical Sciences, New Delhi, India. Electronic address: pradeepguptaneuro@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDirect oral anticoagulants (DOACs) are increasingly preferred over vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF), including valvular (VAF) and non-valvular (NVAF). This network meta-analysis aimed to evaluate and compare the efficacy and safety of different DOACs versus VKAs in patients with AF.

methodsA Bayesian network meta-analysis was conducted to estimate odds ratios (ORs) with 95 % credible intervals (CrIs).

results43 RCTs were included (30 VAF, 13 NVAF). Dabigatran (OR 0.77, 95 % CrI 0.68-0.87) demonstrated the strongest reduction in ischemic stroke/systemic embolism, followed by apixaban (0.81, 0.73-0.91). All DOACs were associated with reduced risk of hemorrhagic stroke.

conclusionDOACs, particularly apixaban and dabigatran, showed superior efficacy and safety compared with VKAs, with apixaban emerging as the most favorable overall option. However, these findings are derived from indirect rather than direct head-to-head comparisons among DOACs and VKAs and should therefore be interpreted with caution.

Indexed as

AnticoagulantsAtrial FibrillationRandomized Controlled Trials as TopicStrokeAdministration, OralGlobal HealthHumansNetwork Meta-Analysis as TopicAnticoagulantsAtrial fibrillationDirect oral anticoagulantsMajor bleedingNetwork meta-AnalysisStroke preventionVitamin K antagonists

Identifiers

PMID41380911
PMCPMC13133535

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.