| Title |
Systematic review and network meta-analysis of stroke prevention treatments in patients with atrial fibrillation
|
|---|---|
| Published in |
Clinical Pharmacology : Advances and Applications, August 2016
|
| DOI | 10.2147/cpaa.s105165 |
| Pubmed ID | |
| Authors |
Amy Tawfik, Joanna M Bielecki, Murray Krahn, Paul Dorian, Jeffrey S Hoch, Heather Boon, Don Husereau, Petros Pechlivanoglou |
| Abstract |
In the last 4 years, four novel oral anticoagulants have been developed as alternatives to warfarin and antiplatelet agents for stroke prevention in atrial fibrillation (AF) patients. The objective of this review was to estimate the comparative effectiveness of all antithrombotic treatments for AF patients. Data sources were Medline Ovid (1946 to October 2015), Embase Ovid (1980 to October 2015), and the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 9, 2015). Randomized controlled trials of AF patients were selected if they compared at least two of the following: placebo, aspirin, aspirin and clopidogrel combination therapy, adjusted-dose warfarin (target international normalized ratio 2.0-3.0), dabigatran, rivaroxaban, apixaban, and edoxaban. Bayesian network meta-analyses were conducted for outcomes of interest (all stroke, ischemic stroke, myocardial infarction, overall mortality, major bleeding, and intracranial hemorrhage). Based on 16 randomized controlled trials of 96,826 patients, all oral anticoagulants were more effective than antiplatelet agents at reducing the risk of ischemic stroke and all strokes. Compared to warfarin, dabigatran 150 mg (rate ratio 0.65, 95% credible interval 0.52-0.82) and apixaban (rate ratio 0.82, 95% credible interval 0.69-0.97) reduced the risk of all strokes. Dabigatran 150 mg was also more effective than warfarin at reducing ischemic stroke risk (rate ratio 0.76, 95% credible interval 0.59-0.99). Aspirin, apixaban, dabigatran 110 mg, and edoxaban were associated with less major bleeding than warfarin. All oral anticoagulants reduce the risk of stroke in AF patients. Some novel oral anticoagulants are associated with a lower stroke and/or major bleeding risk than warfarin. In addition to the safety and effectiveness of drug therapy, as reported in this study, individual treatment recommendations should also consider the patient's underlying stroke and bleeding risk profile. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Japan | 1 | 17% |
| Canada | 1 | 17% |
| Unknown | 4 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 67% |
| Science communicators (journalists, bloggers, editors) | 1 | 17% |
| Practitioners (doctors, other healthcare professionals) | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 127 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | <1% |
| Slovenia | 1 | <1% |
| Brazil | 1 | <1% |
| Unknown | 124 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 22 | 17% |
| Student > Bachelor | 12 | 9% |
| Other | 11 | 9% |
| Researcher | 11 | 9% |
| Student > Postgraduate | 8 | 6% |
| Other | 31 | 24% |
| Unknown | 32 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 52 | 41% |
| Pharmacology, Toxicology and Pharmaceutical Science | 15 | 12% |
| Nursing and Health Professions | 3 | 2% |
| Economics, Econometrics and Finance | 3 | 2% |
| Unspecified | 2 | 2% |
| Other | 8 | 6% |
| Unknown | 44 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 January 2020.
All research outputs
#3,026,500
of 25,374,917 outputs
Outputs from Clinical Pharmacology : Advances and Applications
#24
of 179 outputs
Outputs of similar age
#53,357
of 381,029 outputs
Outputs of similar age from Clinical Pharmacology : Advances and Applications
#2
of 3 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. Compared to these this one has done well and is in the 88th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 179 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one has done well, scoring higher than 86% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 381,029 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 3 others from the same source and published within six weeks on either side of this one.