
Electrophysiology
DOACs vs warfarin, bleeding risk, and stroke prevention
Synthesized from 209 evidence-backed clinical questions linked to this topic — 83 supporting the intervention, 75 against the intervention, 10 still contested.
No clear lean — the placed evidence is contested
83
Favor benefit
40% of all
75
Favor harm
36% of all
41 more (20%) still untested — not placed on the axis.
Low certainty on 76% of questions
Does ethanol vs placebo improve outcomes in Persistent atrial fibrillation?
Low Certainty− Favors harmethanol vs placebo
59 studies (25,167,216 patients) provide low-certainty evidence against benefit of ethanol for the outcome in Persistent atrial fibrillation.
Does beta blockers vs placebo improve outcomes in Atrial Fibrillation?
Low Certainty+ Favors benefitbeta blockers vs placebo
19 studies (4,622,940 patients) provide low-certainty evidence for benefit of beta blockers for the outcome in Atrial Fibrillation.
Does warfarin vs doac improve outcomes in Atrial Fibrillation?
Low Certainty− Favors harmwarfarin vs doac
5 studies (2,398,862 patients) provide low-certainty evidence against benefit of warfarin for the outcome in Atrial Fibrillation.
Does direct oral anticoagulants vs warfarin improve outcomes in Obesity?
Low Certainty+ Favors benefitdirect oral anticoagulants vs warfarin
5 studies (2,171,600 patients) provide low-certainty evidence for benefit of direct oral anticoagulants for the outcome in Obesity.
Does beta-blockers vs calcium channel blockers improve outcomes in Atrial Fibrillation?
Low Certainty+ Favors benefitbeta-blockers vs calcium channel blockers
3 studies (1,981,412 patients) provide low-certainty evidence for benefit of beta-blockers for the outcome in Atrial Fibrillation.
Does vitamin k antagonists vs placebo improve outcomes in HEART-VALVE, MECHANICAL?
Low Certainty− Favors harmvitamin k antagonists vs placebo
55 studies (1,622,061 patients) provide low-certainty evidence against benefit of vitamin k antagonists for the outcome in HEART-VALVE, MECHANICAL.
Does oral anticoagulants vs placebo improve Stroke (Safety Event) in Atrial Fibrillation?
Insufficient~ Mixed resultsoral anticoagulants vs placebo · Stroke (Safety Event)
11 studies (240,230 patients) provide insufficient evidence with mixed findings regarding oral anticoagulants for Stroke (Safety Event) in Atrial Fibrillation.
Does noac vs salicylic acid 120 mg/ml topical solution improve outcomes in Atrial Fibrillation?
Insufficient~ Mixed resultsnoac vs salicylic acid 120 mg/ml topical solution
8 studies (746,143 patients) provide insufficient evidence with mixed findings regarding noac for the outcome in Atrial Fibrillation.
Does apixaban vs rivaroxaban improve outcomes in Thromboembolism?
Insufficient~ Mixed resultsapixaban vs rivaroxaban
7 studies (778 patients) provide insufficient evidence with mixed findings regarding apixaban for the outcome in Thromboembolism.
Does flecainide vs propafenone improve outcomes in Atrial Fibrillation?
Insufficient~ Mixed resultsflecainide vs propafenone
7 studies (1,390 patients) provide insufficient evidence with mixed findings regarding flecainide for the outcome in Atrial Fibrillation.
Emerging evidence with 100 primary claims
Specific, answerable questions in this area — each with its own synthesized evidence and consensus. Open one to see the forest plot, source trials, and how the consensus has changed over time.
Does oral anticoagulation vs placebo improve All-Cause Mortality in Atrial Fibrillation?
Low Certainty+ Favors benefitoral anticoagulation vs placebo · All-Cause Mortality
Does dabigatran vs warfarin improve outcomes in HEART-VALVE, MECHANICAL?
Low Certainty+ Favors benefitdabigatran vs warfarin · Ventricular Arrhythmia
Does rivaroxaban vs apixaban improve outcomes?
Low Certainty+ Favors benefitrivaroxaban vs apixaban · Cardiac Index
Does oral anticoagulants vs placebo improve Intracranial Hemorrhage in Atrial Fibrillation?
Low Certainty+ Favors benefitoral anticoagulants vs placebo · Intracranial Hemorrhage
Does warfarin vs placebo improve All-Cause Mortality in Atrial Fibrillation?
Low Certainty+ Favors benefitwarfarin vs placebo · All-Cause Mortality
Does rivaroxaban vs apixaban improve outcomes in Venous Thromboembolism?
Low Certainty+ Favors benefitrivaroxaban vs apixaban · Cardiac Output
Does doac vs placebo improve Myocardial Infarction Hospitalization in Atrial Fibrillation?
Low Certainty+ Favors benefitdoac vs placebo · Myocardial Infarction Hospitalization
Does apixaban vs enoxaparin improve outcomes in Venous Thromboembolism?
Low Certainty− Favors harmapixaban vs enoxaparin · Cardiac Output
Questions where the synthesized consensus has shifted as new trials were indexed.
Sessions from public journal clubs on Synapse. RSVP to join the live discussion.
Prolonged Infusion of Eptifibatide as Bridge Therapy Between Bare‐Metal Stent Insertion and Cardiovascular Surgery: Case Report and Review of the Literature
Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy — Pickett A — Mar 2010
Aspirin for venous thromboprophylaxis after fracture: ready for prime time?
European Heart Journal — Vergallo R — Mar 2023
Management of Hemorrhage with the Target-Specific Oral Anticoagulants
Hospital Practice — Pluym M — Aug 2014
Bleeding complications of targeted oral anticoagulants: what is the risk?
Hematology — Levine M — Nov 2014
Prothrombin Time Tests for the Monitoring of Direct Oral Anticoagulants and Their Evaluation as Indicators of the Reversal Effect
Clinical and Applied Thrombosis/Hemostasis — Nagakari K — Mar 2016
Elite athletes and anticoagulant therapy: an intermittent dosing strategy
Hematology — Moll S — Nov 2018
Anticoagulant activity of direct factor Xa inhibitors as a tool to ensure the effectiveness and safety of drugs intake
Kardiologiia — Вавилова Т — Dec 2019
Plasma levels do not predict thrombin generation in patients taking direct oral anticoagulants
International Journal of Laboratory Hematology — Metze M — Jun 2021
Dose adjustment based on the plasma level measurement used anti-FXa chromogenic assay on the use of non-vitamin K antagonist oral anticoagulants (NOACs) improved the overall benefit of NOACs dosing in patients with atrial fibrillation
EP Europace — Suwa M — Sep 2021
Comparing the efficacy and safety of direct oral anticoagulants versus Vitamin K antagonists in patients with antiphospholipid syndrome: a systematic review and meta-analysis
Blood Coagulation & Fibrinolysis — Wu X — Jul 2022
Usual On-therapy Ranges of Drug Concentrations in Patients with Atrial Fibrillation Treated with Direct Oral Anticoagulants: A Systematic Review and Meta-analysis
Thrombosis and Haemostasis — Vries T — Nov 2024
Cost Saving Potential of an Early Detection of Atrial Fibrillation in Patients after ICD Implantation
BioMed Research International — Reinhold T — Aug 2018
The evidence sections above show what the literature supports; this is what the field is still arguing about. Open a debate for the camps, the named voices, and the vote.
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Anticoagulation in AF (also known as DOAC AF, NOAC atrial fibrillation, AF anticoagulation). DOACs vs warfarin, bleeding risk, and stroke prevention
Synapse tracks 8 specific clinical questions in Anticoagulation in AF, each synthesized independently from its own trial evidence. They include: "Does oral anticoagulation vs placebo improve All-Cause Mortality in Atrial Fibrillation?"; "Does dabigatran vs warfarin improve outcomes in HEART-VALVE, MECHANICAL?"; "Does rivaroxaban vs apixaban improve outcomes?"; "Does oral anticoagulants vs placebo improve Intracranial Hemorrhage in Atrial Fibrillation?"; "Does warfarin vs placebo improve All-Cause Mortality in Atrial Fibrillation?".
As of 2026-09-01, the scientific consensus on Anticoagulation in AF is emerging. Emerging evidence with 100 primary claims Based on 100 analyzed claims across Synapse's enriched corpus, the evidence shows.
This evidence brief synthesizes Synapse's enriched cardiology corpus; cite as synapsesocial.com/topics/anticoagulation-in-af.
Deterministic synthesis from Synapse's enriched corpus — 129 words. No AI-generated novel content; every figure is sourced from the underlying paper, guideline, or trial record linked on this page.
Explore every Anticoagulation in AF paper on Synapse with AI-enriched clinical evidence, PICO analysis, and methodology classification.
Search Anticoagulation in AF papersPowered by Synapse — AI-enriched analysis of 600,000+ peer-reviewed papers
McMaster University Medical Centre
h-index 119 · 76k citations
Most-cited researchers publishing on Anticoagulation in AF.