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Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials
Abstract
Background Four new oral anticoagulants compare favourably with warfarin for stroke prevention in patients with atrial fibrillation; however, the balance between efficacy and safety in subgroups needs better definition. We aimed to assess the relative benefit of new oral anticoagulants in key subgroups, and the effects on important secondary outcomes.Methods We searched Medline from Jan 1, 2009, to Nov 19, 2013, limiting searches to phase 3, randomised trials of patients with atrial fibrillation who were randomised to receive new oral anticoagulants or warfarin, and trials in which both efficacy and safety outcomes were reported. We did a prespecified meta-analysis of all 71,683 participants included in the RE-LY, ROCKET AF, ARISTOTLE, and ENGAGE AF-TIMI 48 trials. The main outcomes were stroke and systemic embolic events, ischaemic stroke, haemorrhagic stroke, all-cause mortality, myocardial infarction, major bleeding, intracranial haemorrhage, and gastrointestinal bleeding. We calculated relative risks (RRs) and 95% CIs for each outcome. We did subgroup analyses to assess whether differences in patient and trial characteristics affected outcomes. We used a random-effects model to compare pooled outcomes and tested for heterogeneity.Findings 42,411 participants received a new oral anticoagulant and 29,272 participants received warfarin. New oral anticoagulants significantly reduced stroke or systemic embolic events by 19% compared with warfarin (RR 0·81, 95% CI 0·73-0·91; p<0·0001), mainly driven by a reduction in haemorrhagic stroke (0·49, 0·38-0·64; p<0·0001). New oral anticoagulants also significantly reduced all-cause mortality (0·90, 0·85-0·95; p=0·0003) and intracranial haemorrhage (0·48, 0·39-0·59; p<0·0001), but increased gastrointestinal bleeding (1·25, 1·01-1·55; p=0·04). We noted no heterogeneity for stroke or systemic embolic events in important subgroups, but there was a greater relative reduction in major bleeding with new oral anticoagulants when the centre-based time in therapeutic range was less than 66% than when it was 66% or more (0·69, 0·59-0·81 vs 0·93, 0·76-1·13; p for interaction 0·022). Low-dose new oral anticoagulant regimens showed similar overall reductions in stroke or systemic embolic events to warfarin (1·03, 0·84-1·27; p=0·74), and a more favourable bleeding profile (0·65, 0·43-1·00; p=0·05), but significantly more ischaemic strokes (1·28, 1·02-1·60; p=0·045).Interpretation This meta-analysis is the first to include data for all four new oral anticoagulants studied in the pivotal phase 3 clinical trials for stroke prevention or systemic embolic events in patients with atrial fibrillation. New oral anticoagulants had a favourable risk-benefit profile, with significant reductions in stroke, intracranial haemorrhage, and mortality, and with similar major bleeding as for warfarin, but increased gastrointestinal bleeding. The relative efficacy and safety of new oral anticoagulants was consistent across a wide range of patients. Our findings offer clinicians a more comprehensive picture of the new oral anticoagulants as a therapeutic option to reduce the risk of stroke in this patient population.Funding None.
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In the citing paper
“Oral anticoagulation (OAC) with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) markedly reduces stroke and mortality in AF patients.38,39”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
In the citing paper
“OAC therapy can prevent the majority of ischaemic strokes in AF patients and can prolong life.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
In the citing paper
“and hence there is strong evidence that patients with a CHA 2 DS 2 -VASc risk score of 2 or more in men, and 3 or more in women benefit from OAC.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
In the citing paper
“Controlled trials studying OAC in AF patients have been enriched for patients at high risk of stroke, 38,39,42,194,201,329,351,352”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
In the citing paper
“Mortality was 10% lower in patients randomized to NOAC therapy (RR 0.90; 95% CI 0.85-0.95;P = 0.0003) and intracranial haemorrhage was halved (RR 0.48; 95% CI 0.39-0.59;P < 0.0001), while gastrointestinal bleeding events were more frequent (RR 1.25; 95% CI 1.01-1.55;P = 0.04).39”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
In the citing paper
“NOACs in these dosages significantly reduced stroke or systemic embolic events by 19% compared with warfarin (RR 0.81; 95% CI 0.73-0.91;P < 0.0001), mainly driven by a reduction in haemorrhagic stroke (RR 0.49; 95% CI 0.38-0.64;P < 0.0001).”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
In the citing paper
“A meta-analysis 39 based on the highdose treatment groups of the pivotal studies of warfarin versus NOACs included 42,411 patients receiving a NOAC and 29,272 receiving warfarin.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
In the citing paper
“Good data are available to support the use of anticoagulants in older patients from BAFTA (Birmingham Atrial Fibrillation Treatment of the Aged Study), 362 the NOAC trials, 39 and from analyses in elderly Americans (Medicare).396”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [39]
Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Dabigatran versus warfarin in patients with atrial fibrillation
Connolly, S. J., Ezekowitz, M. D., Yusuf, S., Eikelboom, J., Oldgren, J., Parekh, A., Pogue, J., Reilly, P. A., Themeles, E., Varrone, J., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0905561 · Cited by 11,215
Rivaroxaban versus warfarin in nonvalvular atrial fibrillation
Patel, M. R., Mahaffey, K. W., Garg, J., Pan, G., Singer, D. E., Hacke, W., Breithardt, G., Halperin, J. L., Hankey, G. J., Piccini, J. P., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1009638 · Cited by 9,430
Apixaban versus warfarin in patients with atrial fibrillation
Granger, C. B., Alexander, J. H., McMurray, J. J. V., Lopes, R. D., Hylek, E. M., Hanna, M., Al-Khalidi, H. R., Ansell, J., Atar, D., Avezum, A., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1107039 · Cited by 8,943
Guidelines for the management of atrial fibrillation
Authors/Task Force Members, Camm, A. J., Kirchhof, P. F., Lip, G. Y. H., Schotten, U., Savelieva, I., Ernst, S., Gelder, I. C. V., Al‐Attar, N., Hindricks, G., et al. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq278 · Cited by 5,924
Edoxaban versus warfarin in patients with atrial fibrillation
Giugliano, R. P., Ruff, C. T., Braunwald, E., Murphy, S. A., Wiviott, S. D., Halperin, J. L., Waldo, A. L., Ezekowitz, M. D., Weitz, J. I., Špinar, J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1310907 · Cited by 5,164
Gage, B. F., Waterman, A. D., Shannon, W., Boechler, M., Rich, M. W., & Radford, M. J. (2001) · JAMA · doi:10.1001/jama.285.22.2864 · Cited by 4,832
Hart, R. G., Pearce, L. A., & Aguilar, M. I. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-12-200706190-00007 · Cited by 4,793
Pisters, R., Lane, D. A., Nieuwlaat, R., de Vos, C. B., Crijns, H. J. G. M., & Lip, G. Y. H. (2010) · CHEST Journal · doi:10.1378/chest.10-0134 · Cited by 4,517
Cited by
Sorted by citations
Items 101–200 of 1,004
Vanassche, T., Lauw, M. N., Eikelboom, J. W., Healey, J. S., Hart, R. G., Alings, M., Avezum, A., Diaz, R., Hohnloser, S. H., Lewis, B. S., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehu307 · Cited by 313
Osmancik, P. P., Heřman, D., Neužil, P., Hála, P., Táborský, M., Kala, P., Poloczek, M., Šťásek, J., Haman, L., Branny, M., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.10.023 · Cited by 313
Carnicelli, A., Hong, H., Connolly, S. J., Eikelboom, J. W., Giugliano, R. P., Morrow, D. A., Patel, M. R., Wallentin, L. C., Alexander, J. H., Bahit, M. C., et al. (2022) · Archive ouverte UNIGE (University of Geneva) · Cited by 304
Tzeis, S. E., Gerstenfeld, E. P., Kalman, J. M., Saad, E., Shamloo, A. S., Andrade, J. G., Barbhaiya, C. R., Baykaner, T., Bovéda, S., Calkins, H. G., et al. (2024) · Heart Rhythm · doi:10.1016/j.hrthm.2024.03.017 · Cited by 323
Linde, C. M., Bongiorni, M. G., Birgersdotter-Green, U. M., Curtis, A. B., Deisenhofer, I., Furokawa, T., Gillis, A. M., Haugaa, K. H., Lip, G. Y. H., Gelder, I. C. V., et al. (2018) · EP Europace · doi:10.1093/europace/euy067 · Cited by 308
Impact of Renal Function on Outcomes With Edoxaban in the ENGAGE AF-TIMI 48 Trial
Bohula, E. A., Giugliano, R. P., Ruff, C. T., Kuder, J., Murphy, S. A., Antman, E. M., & Braunwald, E. (2016) · Circulation · doi:10.1161/circulationaha.116.022361 · Cited by 291
Lópes, R. D., Alings, M., Connolly, S. J., Beresh, H., Granger, C. B., Mazuecos, J. B., Boriani, G., Nielsen, J. C., Conen, D., Hohnloser, S. H., et al. (2017) · American Heart Journal · doi:10.1016/j.ahj.2017.04.008 · Cited by 288
Rivaroxaban in Patients with Atrial Fibrillation and a Bioprosthetic Mitral Valve
Guimarães, H. P., Lópes, R. D., Silva, P. G. M. D. B. E., Liporace, I. L., Sampaio, R. O., Tarasoutchi, F., Filho, C. R. H., Patriota, R. D. L. S., Leiria, T. L. L., Lamprea, D., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2029603 · Cited by 295
Kato, E. T., Giugliano, R. P., Ruff, C. T., Koretsune, Y., Yamashita, T., Kiss, R. G., Nordio, F., Murphy, S. A., Kimura, T., Jin, J., et al. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.116.003432 · Cited by 288
Mega, J. L., & Simon, T. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60243-4 · Cited by 297
Healey, J. S., Oldgren, J., Ezekowitz, M. D., Zhu, J., Pais, P., Wang, J., Commerford, P., Janský, P., Avezum, Á., Sigamani, A., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30968-0 · Cited by 292
Vinogradova, Y., Coupland, C. A. C., Hill, T., & Hippisley‐Cox, J. (2018) · BMJ · doi:10.1136/bmj.k2505 · Cited by 296
Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage
Connolly, S. J., Sharma, M., Cohen, A. T., Demchuk, A. M., Członkowska, A., Lindgren, A. G., Molina, C. A., Bereczki, D., Toni, D., Seiffge, D. J., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2313040 · Cited by 284
Less dementia with oral anticoagulation in atrial fibrillation
Friberg, L., & Rosenqvist, M. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehx579 · Cited by 279
Macle, L., Cairns, J. A., Leblanc, K., Tsang, T. S. M., Skanes, A. C., Cox, J. L., Healey, J. S., Bell, A., Pilote, L., Andrade, J. G., et al. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.07.591 · Cited by 275
Rivaroxaban in Rheumatic Heart Disease–Associated Atrial Fibrillation
Connolly, S. J., Karthikeyan, G., Ntsekhe, M., Haileamlak, A., Sayed, A. E., Elghamrawy, A., Damasceno, A. A. M., Avezum, Á., Dans, A. L., Gitura, B., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2209051 · Cited by 277
Kato, M., Uedo, N., Hokimoto, S., Ieko, M., Higuchi, K., Murakami, K., & Fujimoto, K. (2018) · Digestive Endoscopy · doi:10.1111/den.13184 · Cited by 272
Keshishian, A. V., Kamble, S., Pan, X., Mardekian, J., Horblyuk, R. V., Hamilton, M., & Lip, G. Y. H. (2016) · Thrombosis and Haemostasis · doi:10.1160/th16-05-0403 · Cited by 268
Nielsen, P. B., Larsen, T. B., Skjøth, F., Gorst-Rasmussen, A., Rasmussen, L. H., & Lip, G. Y. H. (2015) · Circulation · doi:10.1161/circulationaha.115.015735 · Cited by 265
Causes of Death in Anticoagulated Patients With Atrial Fibrillation
Gómez‐Outes, A., Lagunar-Ruíz, J., Terleira‐Fernández, A., Calvo, G., Suárez-Gea, M. L., & Vargas, E. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.09.944 · Cited by 269
Prevention of stroke: a strategic global imperative
Feigin, V. L., Norrving, B., George, M. G., Foltz, J. L., Roth, G. A., & Mensah, G. A. (2016) · Nature Reviews Neurology · doi:10.1038/nrneurol.2016.107 · Cited by 250
Kim, D., Yang, P., Yu, H. T., Kim, T., Jang, E., Sung, J., Pak, H., Lee, M., Lee, M., Lip, G. Y. H., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz386 · Cited by 252
Raval, A. N., Cigarroa, J. E., Chung, M. K., Díaz‐Sandoval, L. J., Diercks, D., Piccini, J. P., Jung, H. S., Washam, J. B., Welch, B. G., Zazulia, A. R., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000477 · Cited by 251
Mairesse, G., Moran, P., van Gelder, I. V., Elsner, C., Rosenqvist, M., Mant, J., Banerjee, A., Gorenek, B., Brachmann, J., Varma, N., et al. (2018) · Europace · doi:10.1093/europace/eux177 · Cited by 191
Goette, A., Merino, J. L., Ezekowitz, M. D., Zamoryakhin, D., Melino, M. R., Jin, J., Mercuri, M. F., GROSSO, M. A., Serrano-Fernandez, V., Al‐Saady, N., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31474-x · Cited by 249
McIntyre, W. F., Benz, A. P., Becher, N., Healey, J. S., Granger, C. B., Rivard, L., Camm, A. J., Goette, A., Zapf, A., Alings, M., et al. (2023) · Circulation · doi:10.1161/circulationaha.123.067512 · Cited by 247
Searching for Atrial Fibrillation Poststroke
Schnabel, R. B., Hæusler, K. G., Healey, J. S., Freedman, B., Boriani, G., Brachmann, J., Brandes, A., Bustamante, A., Casadei, B., Crijns, H. J. G. M., et al. (2019) · Circulation · doi:10.1161/circulationaha.119.040267 · Cited by 248
Steffel, J., Verhamme, P. B., Potpara, T., Albaladejo, P., Antz, M., Desteghe, L., Hæusler, K. G., Oldgren, J., Reinecke, H., Roldán, V., et al. (2018) · EP Europace · doi:10.1093/europace/euy054 · Cited by 248
2020 Clinical practice guidelines for Acute ST-segment elevation myocardial infarction
Russian Society of Cardiology (2020) · Russian Journal of Cardiology · doi:10.15829/29/1560-4071-2020-4103 · Cited by 271
Sharma, M., Cornelius, V. R., Patel, J. P., Davies, G., & Molokhia, M. (2015) · Circulation · doi:10.1161/circulationaha.114.013267 · Cited by 247
The increasing impact of cerebral amyloid angiopathy: essential new insights for clinical practice
Banerjee, G., Carare, R. O., Cordonnier, C., Greenberg, S. M., Schneider, J. A., Smith, E. E., van Buchem, M. A., van der Grond, J., Verbeek, M. M., & Werring, D. J. (2017) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2016-314697 · Cited by 251
Lip, G. Y. H., Fauchier, L., Freedman, S. B., Gelder, I. C. V., Natale, A., Gianni, C., Nattel, S., Potpara, T., Rienstra, M., Tse, H., et al. (2016) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2016.16 · Cited by 248
Angiolillo, D. J., Goodman, S. G., Bhatt, D. L., Eikelboom, J. W., Price, M. J., Moliterno, D. J., Cannon, C. P., Tanguay, J., Granger, C. B., Mauri, L., et al. (2018) · Circulation · doi:10.1161/circulationaha.118.034722 · Cited by 239
Early versus Later Anticoagulation for Stroke with Atrial Fibrillation
Fischer, U., Koga, M., Strbian, D., Branca, M., Abend, S., Trelle, S., Paciaroni, M., Thomalla, G., Michel, P., Nedeltchev, K., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2303048 · Cited by 237
Wang, K.-L., Lip, G. Y. H., Lin, S., & Chiang, C. (2015) · Stroke · doi:10.1161/strokeaha.115.009947 · Cited by 237
Ischemic Stroke despite Oral Anticoagulant Therapy in Patients with Atrial Fibrillation
Seiffge, D. J., Marchis, G. M. D., Koga, M., Paciaroni, M., Wilson, D., Cappellari, M., Macha, K., Tsivgoulis, G. K., Ambler, G., Arihiro, S., et al. (2020) · Annals of Neurology · doi:10.1002/ana.25700 · Cited by 234
Kirchhof, P. F., Blank, B. F., Calvert, M., Camm, A. J., CHLOUVERAKIS, G. I., Diener, H., Goette, A., Huening, A., Lip, G. Y. H., SIMANTIRAKIS, E. N., et al. (2017) · American Heart Journal · doi:10.1016/j.ahj.2017.04.015 · Cited by 226
2020 Clinical guidelines for Atrial fibrillation and atrial flutter
Arakelyan, M. S., Bockeria, L. A., Vasilieva, E., Sp, G., Golukhova, E. Z., Gorev, M. V., Davtyan, K. V., Drapkina, O. M., Станиславовна, К. Е., Kuchinskaya, Е. А., et al. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4594 · Cited by 258
Ray, W. A., Chung, C. P., Murray, K. T., Smalley, W. E., Daugherty, J. R., Dupont, W. D., & Stein, C. M. (2018) · JAMA · doi:10.1001/jama.2018.17242 · Cited by 222
Lip, G. Y. H., Coca, A., Kahan, T., Boriani, G., Manolis, A. S., Olsen, M. H., Oto, A., Potpara, T., Steffel, J., Marín, F. R., et al. (2017) · EP Europace · doi:10.1093/europace/eux091 · Cited by 233
Gastrointestinal Safety of Direct Oral Anticoagulants: A Large Population-Based Study
Abraham, N. S., Noseworthy, P. A., Yao, X., Sangaralingham, L. R., & Shah, N. D. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.12.018 · Cited by 219
Steinberg, B. A., Gao, H., Shrader, P., Pieper, K., Thomas, L. E., Camm, A. J., Ezekowitz, M. D., Fonarow, G. C., Gersh, B. J., Goldhaber, S. Z., et al. (2017) · American Heart Journal · doi:10.1016/j.ahj.2017.08.011 · Cited by 224
Aspirin-free strategies in cardiovascular disease and cardioembolic stroke prevention
Capodanno, D., Mehran, R., Valgimigli, M., Baber, U., Windecker, S., Vranckx, P., Dangas, G., Rollini, F., Kimura, T., Collet, J., et al. (2018) · Nature Reviews Cardiology · doi:10.1038/s41569-018-0049-1 · Cited by 220
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Rivard, L., Friberg, L., Conen, D., Healey, J. S., Berge, T., Boriani, G., Brandes, A., Calkins, H., Camm, A. J., Chen, L. Y., et al. (2022) · Circulation · doi:10.1161/circulationaha.121.055018 · Cited by 214
Mehta, S. R., Bainey, K. R., Cantor, W. J., Lordkipanidzé, M., Marquis‐Gravel, G., Robinson, S. D., Sibbald, M., So, D. Y. F., Wong, G. C., Abunassar, J. G., et al. (2017) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2017.12.012 · Cited by 213
2024 Clinical practice guidelines for Chronic heart failure
Galyavich, A. S., Tereshchenko, S. N., Uskach, T. M., Ageev, F. T., Aronov, D. M., Arutyunov, G. P., Begrambekova, Y. L., Belenkov, Y. N., Boytsov, S. A., Bubnova, M. G., et al. (2024) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2024-6162 · Cited by 251
Healey, J. S., Gladstone, D. J., Swaminathan, B., Eckstein, J., Mundl, H., Epstein, A. E., Hæusler, K. G., Mikulík, R., Kasner, S. E., Toni, D., et al. (2019) · JAMA Neurology · doi:10.1001/jamaneurol.2019.0617 · Cited by 209
Klijn, C. J. M., Paciaroni, M., Berge, E., Korompoki, E., Kõrv, J., Lal, A., Jukka Putaala, A., & Werring, D. J. (2019) · European Stroke Journal · doi:10.1177/2396987319841187 · Cited by 213
Ko, D., Chung, M. K., Evans, P. T., Benjamin, E. J., & Helm, R. H. (2024) · JAMA · doi:10.1001/jama.2024.22451 · Cited by 232
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Pokorney, S. D., Piccini, J. P., Stevens, S. R., Patel, M. R., Pieper, K. S., Halperin, J. L., BREITHARDT, G. E., Singer, D. E., Hankey, G. J., Hacke, W., et al. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.002197 · Cited by 206
Violi, F., Soliman, E. Z., Pignatelli, P., & Pastori, D. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.116.003347 · Cited by 202
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Yaghi, S. R., Bernstein, R. A., PASSMAN, R. S., Okin, P. M., & Furie, K. L. (2017) · Circulation Research · doi:10.1161/circresaha.116.308447 · Cited by 195
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Chai‐Adisaksopha, C., Hillis, C., Isayama, T., Lim, W., Iorio, A., & Crowther, M. A. (2015) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.13139 · Cited by 192
Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management
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Chan, N., Sobieraj‐Teague, M., & Eikelboom, J. W. (2020) · The Lancet · doi:10.1016/s0140-6736(20)32439-9 · Cited by 197
Mega, J. L., Walker, J. R., Ruff, C. T., Vandell, A. G., Nordio, F., Deenadayalu, N., Murphy, S. A., Lee, J., Mercuri, M. F., Giugliano, R. P., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(14)61994-2 · Cited by 190
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Tsutsui, H., Ide, T., Ito, H., Kihara, Y., Kinugawa, K., Kinugawa, S., Makaya, M., Murohara, T., Node, K., Saito, Y., et al. (2021) · Circulation Journal · doi:10.1253/circj.cj-21-0431 · Cited by 191
Carlo, A. D., Bellino, L., Consoli, D., Mori, F., Zaninelli, A., Baldereschi, M., Cattarinussi, A., D’Alfonso, M. G., Gradia, C., Sgherzi, B., et al. (2019) · EP Europace · doi:10.1093/europace/euz141 · Cited by 196
Friedman, D. J., Piccini, J. P., Wang, T., Zheng, J., Malaisrie, S. C., Holmes, D. R., Suri, R. M., Mack, M. J., Badhwar, V., Jacobs, J. P., et al. (2018) · JAMA · doi:10.1001/jama.2017.20125 · Cited by 187
Gastrointestinal Bleeding in Patients With Atrial Fibrillation Treated With Rivaroxaban or Warfarin
Sherwood, M. W., Nessel, C. C., Hellkamp, A. S., Mahaffey, K. W., Piccini, J. P., Suh, E., Becker, R. C., Singer, D. E., Halperin, J. L., Hankey, G. J., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.09.024 · Cited by 187
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Mosarla, R. C., Vaduganathan, M., Qamar, A., Moslehi, J. J., Piazza, G., & Giugliano, R. P. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.01.017 · Cited by 181
Oldgren, J., Åsberg, S., Hijazi, Z., Wester, P. O., Bertilsson, M., Norrving, B. G., & Collaborators, F. T. N. T. (2022) · Circulation · doi:10.1161/circulationaha.122.060666 · Cited by 184
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Fauchier, L., Villejoubert, O., Clémenty, N., Bernard, A. B., Pierre, B., Angoulvant, D., Ivanés, F., Babuty, D., & Lip, G. Y. H. (2016) · The American Journal of Medicine · doi:10.1016/j.amjmed.2016.06.045 · Cited by 179
Joosten, L. P. T., van Doorn, S., van de Ven, P. M., Kohlen, B. T. G., Nierman, M. C., Koek, H. L., Hemels, M. E. W., Huisman, M. V., Kruip, M. J. H. A., Faber, L. M., et al. (2023) · Circulation · doi:10.1161/circulationaha.123.066485 · Cited by 192
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Maura, G., Blotière, P., Bouillon, K., Billionnet, C., Ricordeau, P., Alla, F., & Zureik, M. (2015) · Circulation · doi:10.1161/circulationaha.115.015710 · Cited by 184
Katholing, A., Wallenhorst, C., Freedman, S. B., & Martínez, C. (2015) · Thrombosis and Haemostasis · doi:10.1160/th15-04-0350 · Cited by 174
Hildick‐Smith, D., Landmesser, U., Camm, A. J., Diener, H., Paul, V., Schmidt, B., Settergren, M., Teíger, E., Nielsen‐Kudsk, J. E., & Tondo, C. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehaa169 · Cited by 171
Almutairi, A. R., Zhou, L., Gellad, W. F., Lee, J. K., Slack, M. K., Martin, J. R., & Lo-Ciganic, W.-H. (2017) · Clinical Therapeutics · doi:10.1016/j.clinthera.2017.05.358 · Cited by 179
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Yiin, G. S. C., Howard, D. P. J., Paul, N. L. M., Li, L., Luengo-Fernández, R., Bull, L. M., Welch, S. J. V., Gutnikov, S. A., Mehta, Z., & Rothwell, P. M. (2014) · Circulation · doi:10.1161/circulationaha.114.010942 · Cited by 169
Netuka, I., Ivák, P., Tučanová, Z., Gregor, S., Szárszoi, O., Sood, P., Crandall, D. L., Rimsans, J., Connors, J. M., & Mehra, M. R. (2018) · The Journal of Heart and Lung Transplantation · doi:10.1016/j.healun.2018.03.002 · Cited by 168
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Lip, G. Y. H., Proietti, M., Potpara, T., MANSOUR, M. C., Savelieva, I., Tse, H., Goette, A., Camm, A. J., Blomström‐Lundqvist, C., Gupta, D., et al. (2023) · EP Europace · doi:10.1093/europace/euad226 · Cited by 176
Hohnloser, S. H., Camm, A. J., Cappato, R., Diener, H., Heidbüchel, H., Mont, L., Morillo, C. A., Abozguia, K., Grimaldi, M., Rauer, H., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz190 · Cited by 167
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Diener, H., Easton, J. D., Granger, C. B., Cronin, L., Duffy, C., Cotton, D., Brueckmann, M., & Sacco, R. L. (2015) · International Journal of Stroke · doi:10.1111/ijs.12630 · Cited by 166
Lee, S., Choi, E., Han, K., Cha, M., & Oh, S. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.02.039 · Cited by 165
Eikelboom, J. W., Quinlan, D. J., van Ryn, J., & Weitz, J. I. (2015) · Circulation · doi:10.1161/circulationaha.115.019628 · Cited by 162
Jacobs, V., May, H. T., Bair, T. L., Crandall, B. G., Cutler, M. J., Day, J. D., Mallender, C. D., Osborn, J. S., Stevens, S. M., Weiss, J. P., et al. (2016) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.04.039 · Cited by 163
Testa, S., Paoletti, O., Legnani, C., Dellanoce, C., Antonucci, E., Cosmi, B., Pengo, V., Poli, D., Morandini, R., Testa, R., et al. (2018) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.14001 · Cited by 159
Moayyedi, P., Eikelboom, J. W., Bosch, J., Connolly, S. J., Dyal, L., Shestakovska, O., Leong, D. P., Anand, S. S., Störk, S., Branch, K. R., et al. (2019) · Gastroenterology · doi:10.1053/j.gastro.2019.04.041 · Cited by 167
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Coronary heart disease and atrial fibrillation: a vicious cycle
Liang, F., & Wang, Y. (2020) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00702.2020 · Cited by 157
Essien, U. R., Holmes, D. N., Jackson, L. R., Fonarow, G. C., Mahaffey, K. W., Reiffel, J. A., Steinberg, B. A., Allen, L. A., Chan, P. S., Freeman, J. V., et al. (2018) · JAMA Cardiology · doi:10.1001/jamacardio.2018.3945 · Cited by 155
Borne, R. T., O’Donnell, C. I., Turakhia, M. P., Varosy, P. D., Jackevicius, C. A., Marzec, L., Masoudi, F. A., Hess, P. L., Maddox, T. M., & Ho, P. M. (2017) · BMC Cardiovascular Disorders · doi:10.1186/s12872-017-0671-6 · Cited by 162
Outcome of intracerebral hemorrhage associated with different oral anticoagulants
Wilson, D., Seiffge, D. J., Traenka, C., Basir, G. S., Purrucker, J. C., Rizos, T., Sobowale, O. A., Sallinen, H., Yeh, S., Wu, T. Y., et al. (2017) · Neurology · doi:10.1212/wnl.0000000000003886 · Cited by 155
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Becher, N., Metzner, A., Toennis, T., Kirchhof, P. F., & Schnabel, R. B. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae373 · Cited by 169
Outcomes in a Warfarin-Treated Population With Atrial Fibrillation
Björck, F., Renlund, H., Lip, G. Y. H., Wester, P., Svensson, P. J., & Själander, A. (2016) · JAMA Cardiology · doi:10.1001/jamacardio.2016.0199 · Cited by 153
Pan, K., Singer, D. E., Ovbiagele, B., Wu, Y., Ahmed, M., & Lee, M. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.005835 · Cited by 155
2018 Korean Guideline of Atrial Fibrillation Management
Joung, B., Lee, J., Lee, K. H., Kim, T., Choi, E., Lim, W., Kang, K., Uhm, J., Lim, H. E., Park, J., et al. (2018) · Korean Circulation Journal · doi:10.4070/kcj.2018.0339 · Cited by 157
Metadata
- Authors
- Ruff, C. T., Giugliano, R. P., Braunwald, E., Hoffman, E. B., Deenadayalu, N., Ezekowitz, M. D., Camm, A. J., Weitz, J. I., Lewis, B. S., Parkhomenko, A., Yamashita, T., & Antman, E. M.
- Affiliations
- Brigham and Women's Hospital (US)
- Thomas Jefferson University (US)
- St George's, University of London (GB)
- Thrombosis and Atherosclerosis Research Institute (CA)
- Carmel Medical Center (IL)
- Cardiovascular Institute Hospital (JP)
- Corresponding author
- Ruff, Christian T
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 383
- Issue
- 9921
- Pages
- 955-962
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2152623033
- Cited by
- 5,051
- References
- 45
- Citations by year
- 2026: 249 · 2025: 310 · 2024: 399 · 2023: 426 · 2022: 410 · 2021: 490 · 2020: 521 · 2019: 462 · 2018: 456 · 2017: 447 · 2016: 406 · 2015: 318 · 2014: 139
- FWCI
- 49.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Keywords
- direct oral anticoagulants, warfarin, atrial fibrillation, stroke prevention, systemic embolism, hemorrhagic stroke, intracranial hemorrhage, gastrointestinal bleeding, major bleeding, all-cause mortality, subgroup analysis, factor Xa inhibitors, dabigatran, rivaroxaban, apixaban
- MeSH terms
- Administration, Oral, Anticoagulants, Atrial Fibrillation, Embolism, Humans, Warfarin, Randomized Controlled Trials as Topic, Treatment Outcome, Stroke
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