ArticleChronic obstructive pulmonary diseases (Miami, Fla.)2026
Comparison of Bleeding Risks and All-Cause Death Between Warfarin and Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Chronic Obstructive Pulmonary Disease: A Multicenter Retrospective Cohort Study
Article in Chronic obstructive pulmonary diseases (Miami, Fla.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
Background: Chronic obstructive pulmonary disease (COPD) may influence bleeding in atrial fibrillation (AF). We evaluated bleeding and all-cause death risks under warfarin versus direct oral anticoagulants (DOACs). Methods: Based on a retrospective cohort from 12 centers of patients with AF on oral anticoagulation, we evaluated the associations of COPD and anticoagulant class with clinical outcomes using overlap-weighted logistic regression. Prespecified sensitivity and subgroup analyses were performed. Results: COPD was associated with higher bleeding risk only among patients treated with warfarin (total bleeding: odds ratio [OR] 2.53, 95% confidence interval [CI] 1.00–6.45; risk difference [RD] 9.05%, 95% CI 0.15%–22.50%; minor bleeding: OR 3.00, 95% CI 1.09–8.24; RD 8.53%, 95% CI 0.56%–21.53%). Among patients with AF and COPD, DOACs were associated with reduced risks of total bleeding (OR 0.08, 95% CI 0.01–0.50; RD –8.4%, 95% CI -22.0% to -5.3%) and minor bleeding (OR 0.01; RD -9.5%, 95% CI -23.1% to -4.5%) compared with warfarin. Subgroup analyses suggested that DOACs were associated with increased mortality at estimated glomerular filtration rate (eGFR) ≥60mL/min/1.73m² (OR 3.07, 95% CI 0.78–12.03; RD 9.9%) but lower mortality at eGFR <60mL/min/1.73m² (OR 0.20, 95% CI 0.05–0.78; RD -24.1%). Factor Xa inhibitors were associated with a higher major bleeding risk compared with dabigatran (OR 4.56, 95% CI 1.70–12.26; RD 10.2%, 95% CI 0.2%–20.1%; with a number needed to harm of 10). Conclusion: In AF with comorbid COPD, DOACs minimize bleeding versus warfarin and may confer survival benefit in renal impairment. Differential bleeding risk should be considered when choosing among DOACs.
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.