ReviewCureus2025
Comparative Effectiveness and Safety of Direct Oral Anticoagulants Versus Vitamin K Antagonists in Elderly Patients With Atrial Fibrillation: A Systematic Review.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled 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.
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.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Anticoagulation approaches in hemodialysis: a systematic review of efficacy, safety, and literature gap.International urology and nephrology · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anticoagulant therapy plays a pivotal role in preventing stroke and thromboembolic complications in elderly patients with atrial fibrillation, a population at increased risk for both ischemic and bleeding events. This systematic review evaluates the comparative efficacy and safety of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in elderly patients with nonvalvular atrial fibrillation. A comprehensive literature search was conducted across PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included only English-language randomized controlled trials (RCTs) focusing on patients aged 70 years or older. Five high-quality RCTs met the eligibility criteria. The findings consistently support the non-inferiority or superiority of DOACs compared to warfarin in preventing stroke, with a significantly lower risk of intracranial hemorrhage. However, a higher incidence of extracranial bleeding, particularly gastrointestinal bleeding, was observed with certain DOACs, especially at higher doses in patients aged 80 years and older. The review also highlights a possible role of anticoagulation in cognitive protection, although current evidence is limited. Overall, DOACs appear to be an effective and generally safer alternative to VKAs in elderly patients, but individualized treatment decisions remain essential, particularly in those with advanced age, renal impairment, or elevated bleeding risk.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.