Evidence map›Paper›PMID 41230862›Full record

ArticleEuropean journal of clinical investigation2026

Effectiveness of direct oral anticoagulants for all-cause mortality and cardiovascular events in overweight and obese patients with atrial fibrillation: Insight from the nationwide START registry.

Danilo Menichelli, Gianluca Gazzaniga, Emilia Antonucci, Gualtiero Palareti, Daniela Poli, Pasquale Pignatelli, Daniele Pastori, START2 Register Investigators

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In one paragraph

Article in European journal of clinical investigation, 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. 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

8 authors.

Danilo MenichelliDepartment of General Surgery, Surgical Specialty and Anesthesiology Paride Stefanini, Sapienza University of Rome, Rome, Italy.ORCID https://orcid.org/0000-0001-9467-5903
Gianluca GazzanigaDepartment of General Surgery, Surgical Specialty and Anesthesiology Paride Stefanini, Sapienza University of Rome, Rome, Italy.
Emilia AntonucciArianna Anticoagulazione Foundation, Bologna, Italy.
Gualtiero PalaretiArianna Anticoagulazione Foundation, Bologna, Italy.
Daniela PoliDepartment of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy.ORCID https://orcid.org/0000-0002-5166-6596
Pasquale PignatelliDepartment of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Daniele PastoriDepartment of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.ORCID https://orcid.org/0000-0001-6357-5213
START2 Register Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOverweight and obesity are highly prevalent in atrial fibrillation (AF) patients, yet the best anticoagulant strategy for this group is still unclear. We evaluated the risk of all-cause mortality and cardiovascular events (CVEs) in overweight and obese AF patients treated with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs).

methodsWe analysed 10,259 AF patients on anticoagulants from the prospective nationwide START registry. Overweight was defined as BMI 25-29.9 kg/m

resultsOverall, 6534 (63.7%) patients had BMI >25 kg/m

conclusionsIn this nationwide registry, DOACs were associated with lower risks of mortality and CVEs compared with VKAs across BMI groups, though the CVE effect was not evident in obese patients. These findings suggest a potential mortality advantage of DOACs irrespective of BMI, warranting further confirmation.

Indexed as

AnticoagulantsAtrial FibrillationCardiovascular DiseasesFactor Xa InhibitorsObesityOverweightAdministration, OralAgedAged, 80 and overBody Mass IndexCause of DeathFemaleHumansMaleMiddle AgedProportional Hazards ModelsAnticoagulantsFactor Xa InhibitorsPyrazolesRivaroxabanVitamin Katrial fibrillationBMIDOACobesityoverweightVKA

Identifiers

PMID41230862
PMCPMC12820908

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

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.