Evidence mapPaperPMID 40137084Full record

ArticleJournal of cardiovascular development and disease2025

Oral Anticoagulation Choice and Dosage in Very Elderly Patients with Atrial Fibrillation.

Martha Zergioti, Melina Kyriakou, Andreas S Papazoglou, Anastasios Kartas, Dimitrios V Moysidis, Athanasios Samaras, Efstratios Karagiannidis, Vasileios Kamperidis, Antonios Ziakas, George Giannakoulas

Abstract read
In one paragraph

Article in Journal of cardiovascular development and disease, 2025. 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

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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

10 authors.

Martha ZergiotiMedical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.ORCID 0009-0000-3044-3708
Melina KyriakouMedical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.ORCID 0009-0000-0011-2529
Andreas S PapazoglouMedical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.ORCID 0000-0003-4981-8121
Anastasios KartasMedical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.ORCID 0000-0002-1170-9133
Dimitrios V Moysidis424 General Hospital of Thessaloniki, 56429 Thessaloniki, Greece.
Athanasios SamarasSecond Department of Cardiology, Hippokration Hospital of Thessaloniki, 54643 Thessaloniki, Greece.
Efstratios Karagiannidis424 General Hospital of Thessaloniki, 56429 Thessaloniki, Greece.ORCID 0000-0001-8328-5942
Vasileios KamperidisMedical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.ORCID 0000-0001-8424-6718
Antonios ZiakasMedical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
George GiannakoulasMedical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.ORCID 0000-0001-7491-6319

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSelecting the optimal oral anticoagulation (OAC) therapy for elderly patients with atrial fibrillation (AF) remains challenging. Our real-world study investigates clinical factors guiding OAC prescription patterns and compares outcomes between full- and reduced-dose direct-acting oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in this demographic.

methodsThis post hoc analysis of the MISOAC-AF trial focused on hospitalized AF patients aged ≥ 75 years prescribed OAC at discharge. Predictors of VKA and reduced DOAC dosing were identified using adjusted odds ratios (aORs). Cox regression models calculated adjusted hazard ratios (aHRs) for primary (all-cause mortality) and secondary outcomes (stroke, bleeding, AF or heart failure hospitalization, cardiovascular death).

resultsAmong 450 elderly patients, 63.6% received DOACs and 36.4% received VKAs. Higher CHA2DS2-VASc and HAS-BLED scores and antiplatelet use predicted VKA prescription. Hypertension, prior stroke, and bleeding history favored DOAC use. Advanced age and chronic kidney disease correlated with reduced DOAC dosing. Over a 3.7-year follow-up period, there was no significant difference in all-cause mortality between the DOAC and VKA groups (aHR 0.79, 95% CI 0.58-1.06) or between the full-dose and reduced-dose DOAC groups (aHR 0.96, 95% CI 0.60-1.53). Secondary analyses also did not yield statistically significant results in either comparison.

conclusionsClinical profile parameters in elderly AF patients predict VKA or DOAC use. Clinical outcomes were similar between different OAC therapies.

Indexed as

atrial fibrillationnonagenariansoctogenariansoral anticoagulationvery elderly

Identifiers

PMID40137084
PMCPMC11943373

What Socratic holds

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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.