Evidence map›Paper›PMID 42238268›Full record

ReviewFrontiers in cardiovascular medicine2026

Risk of intracranial hemorrhage with direct oral anticoagulants: an updated network meta-analysis of randomized controlled trials.

Jiana Chen, Qiaomei Chen, Chengfu Guan, Jianping Xia

Abstract readReview
In one paragraph

Review in Frontiers in cardiovascular medicine, 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. The first month after direct oral anticoagulants: a window of vulnerability.Research and practice in thrombosis and haemostasis · 2026
    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.

Jiana ChenDepartment of Pharmacy, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, China.
Qiaomei ChenDepartment of Pharmacy, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, China.
Chengfu GuanDepartment of Pharmacy, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, China.
Jianping XiaDepartment of Pharmacy, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: We updated a network meta-analysis of randomized controlled trials to compare the risk of intracranial hemorrhage (ICH) between direct oral anticoagulants (DOACs) and Vitamin K Antagonists (VKAs) in detail across Venous thromboembolism and atrial fibrillation. Methods: PubMed, EMBASE, Web of Science, and the Cochrane Library databases were searched up to January 5, 2026. The incidence of ICH was investigated. Using frequentist network meta-analysis, interventions that were not compared directly could be compared indirectly by the 95% confidence interval (CI), making the search results more intuitive. Based on surface under the cumulative ranking curves (SUCRA), the relative ranking probability of each group was generated. Results: Twenty randomised controlled trials (127,267 patients) were included. Compared with apixaban, VKAs (OR: 2.40, 95% CI: 1.62-3.56) had a higher risk of bleeding, and the difference was significant. Compared with dabigatran, rivaroxaban (OR: 1.89, 95% CI: 1.18-3.04) and VKAs (OR: 2.83, 95% CI: 2.00-3.99) had a higher risk of bleeding, and the difference was significant. Compared with edoxaban, rivaroxaban (OR: 1.60, 95% CI: 1.04-2.47) and VKAs (OR: 2.39; 95% CI: 1.81-3.17) had a higher risk of bleeding, and the difference was significant. Compared with rivaroxaban, VKAs (OR: 1.50; 95% CI: 1.08-2.07) had a higher risk of bleeding, and the difference was significant. In the ranking of the cumulative probability of ICH, dabigatran (SUCRA 87.6) had the highest safety, followed by apixaban (SUCRA 68.6), edoxaban (SUCRA 67.5), rivaroxaban (SUCRA 26.1), and VKAs (SUCRA 0.2). Conclusions: All DOACs had a lower risk of ICH than VKAs. Dabigatran may be the safest choice among any anticoagulant regarding risk of ICH. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261336668, identifier CRD420261336668.

Indexed as

atrial fibrillationdirect oral anticoagulantsintracranial hemorrhagenetwork meta-analysisvenous thromboembolism

Identifiers

PMID42238268
PMCPMC13226517

What OpenQuestion holds

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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.