ReviewCureus2025
The Impact of Direct Oral Anticoagulants vs. Warfarin on Stroke Prevention in Elderly Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The outcomes of direct oral anticoagulants (DOACs) vs. warfarin have been well established in patients with atrial fibrillation (AF), but evidence regarding their safety and efficacy in preventing stroke or systemic embolism (SE) and reducing major bleeding in elderly patients remains inconclusive. This systematic review and meta-analysis aimed to compare the effectiveness of DOACs and warfarin in AF patients aged 75 years or older. The primary outcomes assessed were stroke prevention, bleeding risk, and all-cause mortality. A comprehensive literature search of databases including PubMed, Cochrane Library, and Google Scholar identified 10 relevant studies, which were included in the meta-analysis. The pooled hazard ratio for the composite outcome of stroke/SE or major bleeding was 0.84 (95% CI, 0.67-1.05; p = 0.12), indicating no statistically significant superiority of DOACs over warfarin in patients aged ≥75 years. The wide 95% CI, crossing unity, reflects imprecision and precludes definitive claims of either superiority or equivalence in this age group. Subgroup analyses suggested that the benefits of DOACs depend on patient age, comorbidities, and polypharmacy, with greater advantages observed in healthier subgroups. Significant heterogeneity was noted in relation to the type of DOAC and differences in follow-up duration. Assessment of publication bias using funnel plots and the Egger regression test indicated no significant bias, supporting the reliability of the findings. While this meta-analysis demonstrates generally favorable outcomes for DOACs, it also underscores the need for further studies to evaluate the long-term safety and feasibility of DOAC therapy in older AF patients, particularly those with complex comorbid conditions.
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Registered trials
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.