Evidence map›Paper›PMID 41364240›Full record

SynthesisHerz2026

Bleeding risk associated with the co-use of direct oral anticoagulants and non-dihydropyridine calcium channel blockers: a meta-analysis.

Francinny Alves Kelly, Elisa Andrade de Faria, Clara Rocha Dantas, Aminah Abrão Fauaz Ritter Lima, Barbara Antonia Dups Talah, Artur de Oliveira Macena Lôbo, Antonio Gabriele Laurinavicius, Fernanda Marciano Consolim-Colombo

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Herz, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Francinny Alves KellyDepartment of Hypertension, Dante Pazzanese Institute of Cardiology, 04012-909, Sao Paulo, Brazil. francinnyalveskelly@gmail.com.ORCID http://orcid.org/0000-0003-0706-6929
Elisa Andrade de FariaDepartment of Medicine, Regional University of Blumenau, 89035212, Blumenau, Brazil.ORCID http://orcid.org/0009-0001-3215-6291
Clara Rocha DantasDepartment of Medicine, University of Buenos Aires, C1121, Ciudad Autónoma de Buenos Aires, Argentina.ORCID http://orcid.org/0009-0001-9661-8539
Aminah Abrão Fauaz Ritter LimaDepartment of Medicine, University Anhembi Morumbi, 13425-380, Piracicaba, Brazil.ORCID http://orcid.org/0009-0004-0047-027X
Barbara Antonia Dups TalahDepartment of Medicine, Pontifical Catholic University of Paraná, 80215-901, Curitiba, Brazil.ORCID http://orcid.org/0009-0002-5788-7098
Artur de Oliveira Macena LôboDepartment of Medicine, Federal University of Pernambuco, 50670-901, Recife, Brazil.ORCID http://orcid.org/0009-0003-0637-0387
Antonio Gabriele LaurinaviciusDepartment of Hypertension, Dante Pazzanese Institute of Cardiology, 04012-909, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0001-6634-4138
Fernanda Marciano Consolim-ColomboHypertension Unit, Heart Institute of Medical school, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0003-3220-019X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOral anticoagulation is a cornerstone of stroke prevention in patients with atrial fibrillation (AF) and elevated thromboembolic risk. However, evidence regarding the association between co-use of direct oral anticoagulants (DOACs) and non-dihydropyridine calcium-channel blockers (CCBs) and bleeding risk remains controversial.

methodsWe systematically searched PubMed, Embase, and the Cochrane Library for randomized clinical trials, cohort, and case-control studies evaluating bleeding risk associated with DOAC + CCB co-use in patients with AF. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for binary outcomes.

resultsNine studies met inclusion criteria, comprising 408,276 patients overall, of whom 67,359 were using DOACs + CCBs. Meta-analysis showed a significantly higher incidence of major bleeding with DOAC + CCB co-use compared with DOAC alone (OR 1.21 [95% CI 1.18-1.43]; p < 0.001; I

conclusionCo-use of DOACs and non-dihydropyridine CCBs is associated with an increased risk of major bleeding, whereas the overall risk of any bleeding does not differ significantly. Large randomized controlled trials are warranted to confirm these findings and to further evaluate the safety of this combination.

Indexed as

AnticoagulantsAtrial FibrillationCalcium Channel BlockersHemorrhageStrokeThromboembolismAdministration, OralAgedCausalityComorbidityDrug Therapy, CombinationFemaleHumansIncidenceMaleRisk FactorsAnticoagulantsCalcium Channel BlockersAtrial fibrillationBleeding riskDirect oral anticoagulantMajor bleedingnon-dihydropyridine calcium chanel blockers

Identifiers

PMID41364240

What Socratic holds

Textmetadata
Read underepoch 390

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.