Evidence map›Paper›PMID 42043183›Full record

ArticleEuropean heart journal. Cardiovascular pharmacotherapy2026

Implementation of novel antithrombotic treatment strategies and outcome improvements in patients with myocardial infarction and atrial fibrillation over 20 years: a nationwide cohort study.

Christian Losciale, Lars Lindhagen, Lars Wallentin, Tomas Jernberg, Joakim Alfredsson, Jonas Oldgren, Gorav Batra

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal. Cardiovascular pharmacotherapy, 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

7 authors.

Christian LoscialeDepartment of Medicine, Nyköpings Lasarett, 611 39 Nyköping, Sweden.ORCID 0009-0000-2249-4548
Lars LindhagenUppsala Clinical Research Center, Uppsala University, 751 85 Uppsala, Sweden.
Lars WallentinDepartment of Medical Sciences, Cardiology, Uppsala University, 751 85 Uppsala, Sweden.ORCID 0000-0003-0378-6531
Tomas JernbergDepartment of Clinical Sciences, Danderyd Hospital, Karolinska Institute, 182 88 Stockholm, Sweden.ORCID 0000-0003-1695-379X
Joakim AlfredssonDepartment of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.ORCID 0000-0002-1415-7178
Jonas OldgrenDepartment of Medical Sciences, Cardiology, Uppsala University, 751 85 Uppsala, Sweden.ORCID 0000-0002-9969-3921
Gorav BatraDepartment of Medical Sciences, Cardiology, Uppsala University, 751 85 Uppsala, Sweden.ORCID 0000-0002-2480-9547

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPatients with acute myocardial infarction (MI) and atrial fibrillation (AF) present challenges in antithrombotic treatment. Effects of newer treatment strategies on outcomes remain uncertain. We assessed implementation of antithrombotic treatment and occurrence of cardiovascular (CV) events and major bleeding in patients with MI and AF. METHODS AND

resultsNationwide data from SWEDEHEART and national health registries were used to identify 71 513 survivors of an acute MI with AF between 2000 and 2021. Changes in antithrombotic therapies over time in 2-year cohorts were analysed, and associations with 1-year outcomes were assessed. The outcomes were ischaemic stroke or systemic embolism, MI, major bleeding, CV mortality and all-cause mortality. Logistic regression was used to standardize for changes in patient characteristics and treatment over time. Oral anticoagulant use increased from 21% in 2000-2001 to 75% in 2020-2021, largely due to adoption of direct oral anticoagulants (DOACs) after the first DOAC approval in 2011, most often combined with a single antiplatelet. Over time, particularly in the last decade, 1-year risk of ischaemic stroke or systemic embolism declined from 6.0% to 2.1%, and CV mortality decreased from 19.8% to 10.5%. Major bleeding increased from 3.9% to 7.6% in 2014-2015, then declined to 6.4% in 2020-2021, simultaneously with adoption of single rather than dual antiplatelet therapy in combination with DOAC.

conclusionBetween 2000 and 2021, among patients with MI and AF, we observed reductions in 1-year risks of ischaemic stroke or systemic embolism and CV mortality, occurring during a period of increased prescription of oral anticoagulants, particularly DOACs. KEY QUESTION AND

findingsKey QuestionHave recent clinical trial findings on antithrombotic therapy in patients with myocardial infarction and concomitant atrial fibrillation been implemented, and have they resulted in any improvement in 1-year outcomes?Key FindingIn patients with myocardial infarction and atrial fibrillation, we observed substantial reductions in 1-year risks of ischaemic stroke or systemic embolism and cardiovascular mortality, associated with increased prescribing of oral anticoagulants, particularly DOACs.

Indexed as

AnticoagulantsAtrial FibrillationFactor Xa InhibitorsFibrinolytic AgentsIschemic StrokeMyocardial InfarctionPlatelet Aggregation InhibitorsPractice Patterns, Physicians'Administration, OralAgedAged, 80 and overFemaleHemorrhageHumansMaleMiddle AgedAnticoagulantsFactor Xa InhibitorsFibrinolytic AgentsPlatelet Aggregation InhibitorsAtrial fibrillationMyocardial infarctionOral anticoagulants

Identifiers

PMID42043183
PMCPMC13367244

What OpenQuestion holds

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LicenceCC BY
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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.