Evidence map›Paper›PMID 41438731›Full record

ReviewBlood vessels, thrombosis & hemostasis2026

DOACs vs warfarin in AF with comorbid CKD or valvular disease: a systematic review and meta-analysis.

Aileen Liang, Cathy Wang, Alla E Iansavitchene, Alejandro Lazo-Langner

Abstract readReview
In one paragraph

Review in Blood vessels, thrombosis & hemostasis, 2026. 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

4 authors.

Aileen LiangSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Cathy WangSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Alla E IansavitcheneLibrary Services, London Health Sciences Centre, London, ON, Canada.
Alejandro Lazo-LangnerSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Direct oral anticoagulant agents (DOACs) are indicated to prevent vascular events in patients with atrial fibrillation (AF) without concomitant valvular disease or severe chronic kidney disease (CKD), groups in which warfarin is the preferred choice. We aimed to evaluate the safety of DOACs in these populations compared to warfarin. We conducted a systematic review in MEDLINE, Embase, and Evidence Based Medicine Reviews to identify randomized-controlled trials (RCTs) and non-RCTs assessing warfarin or DOACs (rivaroxaban, dabigatran, apixaban, or edoxaban) in patients with AF with concomitant valvular disease or CKD (according to Kidney Disease Outcomes Quality Initiative guidelines) that reported on bleeding, stroke, or systemic/arterial thromboembolism. Meta-analysis was performed for eligible studies using the Mantel-Haenszel method random effects model. Of 3172 screened studies, we included 110 studies (310 478 patients with concomitant AF and CKD; 99 299 patients with concomitant AF and valve disease). Meta-analysis showed that, compared to warfarin, in patients with concomitant AF and CKD, DOACs were associated with reduced bleeding (odds ratio [OR], 0.66; 95% confidence interval [Cl], 0.49-0.88;

Identifiers

PMID41438731
PMCPMC12720180

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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.