| Title |
Perioperative Safety and Efficacy of Different Anticoagulation Strategies With Direct Oral Anticoagulants in Pulmonary Vein Isolation A Meta-Analysis
|
|---|---|
| Published in |
JACC: Clinical Electrophysiology, June 2018
|
| DOI | 10.1016/j.jacep.2018.04.006 |
| Pubmed ID | |
| Authors |
Riccardo Gorla, Francesco Dentali, Matteo Crippa, Jacopo Marazzato, Matteo Nicola Dario Di Minno, Anna Maria Grandi, Roberto De Ponti |
| Abstract |
The purpose of this study was to evaluate the safety and efficacy of uninterrupted and interrupted direct oral anticoagulant (DOAC) administration in patients undergoing pulmonary vein isolation (PVI). The optimal periprocedural management of DOACs in patients undergoing PVI is not well defined, and different strategies are used. A systematic search of PubMed/MEDLINE, Ovid/MEDLINE, and EMBASE was performed. Three strategies for periprocedural DOAC administration were considered: uninterrupted, mildly interrupted (<12 h), and interrupted (≥12 h). Primary endpoints were major bleeding (MB) and thromboembolic (TE) complications; pooled weighted mean incidence (WMI) was calculated using a random-effects model. A secondary endpoint was the WMI of overall bleeding (OB). The analysis included 43 studies for a total of 8,362 patients. DOACs showed similar safety and efficacy in the 3 subgroups. The WMI of MB was 1.02%, 1.49%, and 1.17% for the uninterrupted, mildly interrupted, and interrupted strategy, respectively; the WMI of TE complications was 0.16%, 0.46%, and 0.49% for the uninterrupted, mildly interrupted, and interrupted strategy, respectively, with no heterogeneity. OB appeared to be higher in uninterrupted (6.33%) and mildly interrupted (8.62%) groups compared with the interrupted (3.53%), with substantial heterogeneity among studies. No interaction was found between the incidence of MB and TE complications and different DOACs. In patients undergoing PVI, these 3 anticoagulation strategies may have similar safety and efficacy in terms of MB and TE complications. OB appears to be higher in uninterrupted and mildly interrupted strategies compared with the interrupted strategy. No substantial differences were observed among DOACs regarding the incidence of MB and TE complications. |
X Demographics
The data shown below were collected from the profiles of 36 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 7 | 19% |
| Australia | 2 | 6% |
| Spain | 2 | 6% |
| United Arab Emirates | 1 | 3% |
| Venezuela, Bolivarian Republic of | 1 | 3% |
| Norway | 1 | 3% |
| Belgium | 1 | 3% |
| Brazil | 1 | 3% |
| France | 1 | 3% |
| Other | 4 | 11% |
| Unknown | 15 | 42% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 26 | 72% |
| Practitioners (doctors, other healthcare professionals) | 6 | 17% |
| Scientists | 2 | 6% |
| Science communicators (journalists, bloggers, editors) | 2 | 6% |
Mendeley readers
The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 35 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 14% |
| Student > Ph. D. Student | 5 | 14% |
| Student > Master | 4 | 11% |
| Student > Bachelor | 3 | 9% |
| Researcher | 2 | 6% |
| Other | 8 | 23% |
| Unknown | 8 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 54% |
| Arts and Humanities | 1 | 3% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 3% |
| Nursing and Health Professions | 1 | 3% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Other | 2 | 6% |
| Unknown | 10 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 30. 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 19 July 2018.
All research outputs
#1,333,029
of 25,559,053 outputs
Outputs from JACC: Clinical Electrophysiology
#272
of 1,563 outputs
Outputs of similar age
#28,252
of 343,299 outputs
Outputs of similar age from JACC: Clinical Electrophysiology
#10
of 44 outputs
Altmetric has tracked 25,559,053 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,563 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has done well, scoring higher than 82% of its peers.
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We're also able to compare this research output to 44 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 79% of its contemporaries.