Evidence mapPaperPMID 37445369Full record

ArticleJournal of clinical medicine2023

Oral Anticoagulants after Heart Transplantation-Comparison between Vitamin K Antagonists and Direct Oral Anticoagulants.

Fabrice F Darche, Lisa C Fabricius, Matthias Helmschrott, Ann-Kathrin Rahm, Philipp Ehlermann, Tom Bruckner, Wiebke Sommer, Gregor Warnecke, Norbert Frey, Rasmus Rivinius

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
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

5 citing papers in PubMed, 6 citations in OpenAlex.

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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

10 authors at 1 institution in 1 country.

Fabrice F DarcheDepartment of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.ORCID 0000-0003-4896-9219
Lisa C FabriciusDepartment of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Matthias HelmschrottDepartment of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Ann-Kathrin RahmDepartment of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.ORCID 0000-0002-7509-887X
Philipp EhlermannDepartment of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Tom BrucknerInstitute for Medical Biometry, University of Heidelberg, 69120 Heidelberg, Germany.
Wiebke SommerDepartment of Cardiac Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Gregor WarneckeDepartment of Cardiac Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Norbert FreyDepartment of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Rasmus RiviniusDepartment of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.ORCID 0000-0003-1146-6319
Heidelberg University · DE

Funding

Fondation Coeur - Daniel Wagner, Fondation de Luxembourg n/aGerman Heart Foundation/German Foundation of Heart Research n/aOlympia-Morata-Program of the Faculty of Medicine, University of Heidelberg n/a
6 · The paper itself

Abstract

aimsPatients after heart transplantation (HTX) often require oral anticoagulants (OACs) due to atrial arrhythmias or thromboembolic events but little is known about the post-transplant use of direct oral anticoagulants (DOACs). We investigated the frequency, indications, and complications of DOACs and vitamin K antagonists (VKAs) after HTX.

methodsWe screened all adult patients for the use of post-transplant OACs who underwent HTX at Heidelberg Heart Center between 2000 and 2021. Patients were stratified by type of OAC (DOAC or VKA) and by DOAC agents (apixaban, dabigatran, edoxaban, or rivaroxaban). Indications for OACs comprised atrial fibrillation, atrial flutter, pulmonary embolism, upper and lower extremity deep vein thrombosis, as well as intracardiac thrombus.

resultsA total of 115 of 459 HTX recipients (25.1%) required OACs, including 60 patients with DOACs (52.2%) and 55 patients with VKAs (47.8%). Concerning DOACs, 28 patients were treated with rivaroxaban (46.7%), 27 patients with apixaban (45.0%), and 5 patients with edoxaban (8.3%). We found no significant differences between both groups concerning demographics, immunosuppressive drugs, concomitant medications, indications for OACs, ischemic stroke, thromboembolic events, or OAC-related death. Patients with DOACs after HTX had a significantly lower one-year rate of overall bleeding complications (

conclusionsDOACs were comparable to VKAs concerning the risk of ischemic stroke, thromboembolic events, or OAC-related death but were associated with significantly fewer bleeding complications in HTX recipients.

Indexed as

atrial fibrillationbleedingdirect oral anticoagulantheart transplantationoral anticoagulantstrokevitamin K antagonist

Identifiers

PMID37445369
PMCPMC10342416
OpenAlexW4382583026

What Socratic 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 Socratic graph.