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Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease logoLink to Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
. 2023 Aug 10;12(17):e029810. doi: 10.1161/JAHA.123.029810

Studies on Atrial Fibrillation and Venous Thromboembolism in the Past 20 Years: A Bibliometric Analysis Via CiteSpace and VOSviewer

Lina Miao 1,*, Junhe Shi 1,*, Haixu Yu 3, Lei Song 1, Chunlin Zhu 1, Dazhuo Shi 1,2,, Jie Gao 1,2,
PMCID: PMC10547310  PMID: 37586071

Abstract

ABSTRACT The conjunction of atrial fibrillation (AF) and venous thromboembolism (VTE) is common in clinical practice. Over the last 2 decades, a significant number of articles (2500) have been published about AF and VTE. To effectively analyze and present these vast amounts of information, this study uses bibliometric research methods to categorize and consolidate these publications. The number of publications has increased yearly, especially since 2012. The United States was the most prolific country, with 1054 studies published. The most productive institution was McMaster University. Gregory Y.H. Lip was the most prolific author. The keyword analysis identified that the research focuses from 2003 to 2014 were factor Xa inhibitor, dabigatran etexilate, direct thrombin inhibitor, double‐blind, deep vein thrombosis, molecular weight heparin, stroke prevention, etc. From 2015 to 2016, research mainly focused on venous thromboembolism, antithrombotic therapy, anticoagulant, warfarin, atrial fibrillation, stroke, and pulmonary embolism. Studies during 2017 to 2022 focused on apixaban, direct oral anticoagulant, rivaroxaban, dabigatran, hemorrhage, edoxaban, medicine efficacy and safety, risk factors, clinical management, and vitamin K antagonists. Since 2018, novel oral anticoagulants have been the most commonly used keywords. On the whole, most studies of AF and VTE focus on pathogenesis and therapeutic drugs. The causal relationship between AF and VTE, the effectiveness and safety of novel oral anticoagulants in the treatments, the anticoagulant regimen of AF and VTE co‐disease, and the treatment regimen for vulnerable populations such as the elderly or obese people were the focus of current research and will continue to be the central point of future research.

Keywords: atrial fibrillation, bibliometrics, CiteSpace, venous thromboembolism, visual analysis

Subject Categories: Atrial Fibrillation, Thrombosis


Nonstandard Abbreviations and Acronyms

FXaIs

Factor Xa inhibitors

NOACs

novel oral anticoagulants

NVAF

nonvalvular atrial fibrillation

Atrial fibrillation (AF) is one of the most commonly occurring heart arrhythmias. Approximately one‐fourth of adults develop AF during their lifetime. 1 It was first reported in 1991 that AF significantly increased the incidence of venous thromboembolism (VTE) in patients with stroke. 2 AF induces hemodynamic changes, which potentially promote VTE formation. 3 Most of the previous studies reported the causal link between AF and VTE; however, recent studies found that AF and VTE may be bidirectional or co‐existing. 4 , 5 Many studies have proved that patients with VTE have a significantly higher risk of AF than those without VTE. 6 , 7 , 8

The 2020 European Society of Cardiology guidelines used the CHA2DS2 VASc score (≥2) as indicative of anticoagulation in AF. 9 The initial CHA2DS2 VASc study considered VTE as a vascular disease rather than a routine clinical AF risk. However, when patients with VTE with routine anticoagulation treatment developed AF, the current guidelines do not specify indications for anticoagulation if they had no other risk factors for stroke. To date, no authoritative guidelines recommended the treatment strategy for the co‐occurrence of AF and VTE. In the past 2 decades, the research on AF and VTE has been rapidly increasing, and sorting and summarizing the research progress in this field is helpful to provide suggestions for the treatment of their comorbidities.

This study aims to analyze the bibliometric characteristics of AF and VTE over the past 2 decades, to analyze the history, popular research topics and cutting‐edge trends in this field, and to provide references for clinicians and researchers.

Methods

Search Strategy

A retrospective bibliometric analysis of journal articles published within the last 20 years (November 14, 2003 to November 14, 2022) related to AF and VTE was conducted on November 14, 2022. Literature was retrieved through the Web of ScienceCore Collection according to various preset keywords. Topic search keywords are “venous thromboembolism” and “atrial fibrillation.” For specific retrieval strategies, see Data S1. Articles that had any of the above keywords were included in the search.

Inclusion and Exclusion Criteria

The search results were limited to articles and reviews published in English between 2003 and 2022. Two reviewers (J.H.S. and L.S.) independently screened the literature, and differences were resolved by consensus with the third reviewer (J.G.). Articles were included if AF and VTE were mainly investigated or reported. Articles with nonoriginal studies including narrative reviews, clinical guidelines, or studies with animals as subjects were excluded.

Extraction and Analysis of Bibliometric Data

Bibliometric data was extracted from each article by 3 reviewers (L.N.M., H.X.Y., and C.L.Z.). Information such as the journal title, journal impact factor, publication year, country, affiliation, keywords, citing references and cited references were extracted. In case of disagreement between reviewers, the consensus was adjudicated by the senior author (D.Z.S.).

Data Analysis

CiteSpace software, VOSviewers software, and Excel were used to analyze the demographics of countries, institutions, authors, and research hotspots in the field.

Results

Literature Publication and Citation

A total of 2877 articles in the past 20 years were retrieved from the Web of Science Core Collection. A total of 2500 articles were included for bibliometric analysis by limiting language, time, and article type. Of these, 1594 articles and 906 review articles were included. A simple study flow chart is shown in Figure 1.

Figure 1. Study Flow Chart.

Figure 1

TS indicates topic search; and WoSCC, Web of Science Core Collection.

We plotted the number of publications and citations by year to analyze the development trend of AF and VTE studies during the past 2 decades (Figure 2). Obviously, the number of articles published in this field has risen over the past 20 years. In particular, the average annual number of articles published in this field has reached 121 after 2012, more than 200 after 2017, and peaked at 254 articles published in 2021. The citation frequency of articles has also increased with >9000 citations in 2021.

Figure 2. Number of annual publications and citation frequency relating to AF and VTE from 2003 to 2022.

Figure 2

AF indicates atrial fibrillation; and VTE, venous thromboembolism.

Figure 3 distinguishes between citing references and cited references. After removing the self‐citation, the citing frequency was 37 137 times, and the cited frequency was 61 973 times. The average citation frequency of each publication was 28.3 times (h‐index=118).

Figure 3. Citing literature and cited literature.

Figure 3

Productive Journals and Influential Articles

Figure S1 shows the top 10 journals with the highest number of published articles, including Neurosciences, Peripheral Vascular Disease, and Clinical Neurology.

The dual‐map overlay of journals shows the distribution of relationships between journals, with citing journals on the left and cited journals on the right. The colored path in the dual‐map indicates the reference connections. As shown in Figure 4, there are 2 main reference paths marked in green. One signifies that studies published in medicine, medical, and clinical journals are cited by studies in molecular, biology, genetics journals, and the other shows that studies published in medicine, medical, and clinical journals are published in health, nursing, and medicine journals research citations.

Figure 4. Dual‐map overlay of journals on AF and VTE.

Figure 4

AF indicates atrial fibrillation; and VTE, venous thromboembolism.

Table S1 lists the most influential 50 articles on AF and VTE, which are regarded as classics in this field. Reading these articles is of great significance in enabling a greater understanding of the important research directions in the field of AF and VTE.

Distribution of Countries and Institutions

A total of 577 institutions in 93 countries co‐authored 2500 publications on AF and VTE. As shown in Figure 5, the United States published the most articles (1054), followed by Canada (300), the United Kingdom of Great Britain and Northern Ireland (292), Italy (261), Germany (241), China (158), France (138), and the Netherlands (123 articles). Since 2003, research in this field has been carried out in the United States, Canada, Italy, the United Kingdom of Great Britain and Northern Ireland, and France, while China did not start research in this field until 2009. Among them, only 3 countries have more than 0.1 centrality, namely, the United States, Canada, and France, with the centralities of 0.25, 0.11, and 0.1, respectively.

Figure 5. Distribution of countries engaged in AF and VTE research.

Figure 5

AF indicates atrial fibrillation; and VTE, venous thromboembolism.

The publication institutions are shown in Figure 6 (node=577, links=2090). The top 5 institutions for the number of publications are McMaster University, Harvard Medical School, University of Birmingham, University of Insubria, and Duke University. The centrality of the above‐mentioned institutions is 0.27, 0.03, 0.07, 0.15, and 0.12, respectively, among which 3 institutions’ centralities exceed 0.1, indicating a low degree of cooperation between the different institutions.

Figure 6. Institutions engaged in the research on AF and VTE.

Figure 6

The color of the line represents the time of first co‐occurrence. The thicker the line is, the greater the connection strength is (calculation method based on cosine). AF indicates atrial fibrillation; and VTE, venous thromboembolism.

Distribution of Authors

The top 10 authors published more than 19 papers on AF and VTE, and 3 of them published >30 related articles (Table S2). Gregory Y.H. Lip has the largest number of publications (59), followed by Walter Ageno (47) and Sam Schulman (33). In the network formed by the CiteSpace analysis, centrality is an important parameter to measure the importance of nodes in the network. Nodes whose centrality is >0.1 are called critical nodes and are considered as high‐centrality nodes. The lines between nodes reflect the connections between authors, and the higher centrality of a node is, the higher its frequency contact with other nodes and the more important it is within the whole network. From the author network involved in the study of AF and VTE (Figure S2), several teams studied the relationship between AF and VTE. However, only 3 of the top 10 prolific authors have a centrality of >0.1, which indicates a lack of cooperation among teams in this field.

Keyword Analysis

CiteSpace was used to construct a keyword co‐occurrence map (Figure 7). A total of 792 keywords were extracted, among which 11 words appeared >300 times, 30 words appeared >120 times, and 67 words appeared >50 times. Table S3 shows the top 25 keyword co‐occurrences, which included atrial fibrillation (1551), venous thromboembolism (1387), warfarin (695), rivaroxaban (390), deep vein thrombosis (380), factor Xa inhibitor (378), risk (359), antithrombotic therapy (343), prevention (340), dabigatran (315), and oral anticoagulant (313). Direct oral anticoagulant (280) is central to the study of AF and VTE.

Figure 7. Keyword co‐occurrence map of AF and VTE.

Figure 7

AF indicates atrial fibrillation; and VTE, venous thromboembolism.

Keyword burst detection identifies keywords with sudden increase in frequency within a short period of time, revealing the change in research focuses over time, and reflecting the evolving trend of hotspots. The top 25 keywords for citation burst are shown in Figure 8. Direct thrombin inhibitor was the strongest keyword from 2003 to 2013. After 2018, direct oral anticoagulant has been the strongest keyword for denotation.

Figure 8. CiteSpace visualization map of top 25 keywords with the strongest citation bursts involved in AF and VTE.

Figure 8

AF indicates atrial fibrillation; and VTE, venous thromboembolism.

We used VOSviewer software to cluster the keywords of retrieved documents that change over time. A circle and a label form an element whose color identifies the category and time range to which it belongs. Figure S3 shows 3 colors (purple, green, and yellow), which denote the keyword clustering of the 3 time periods 2003 to 2014, 2015 to 2016, and 2017 to 2022, respectively. The keywords of purple clustering were factor Xa inhibitor (FXaI) dabigatran ester direct thrombin inhibitor double‐blind deep vein thrombosis molecular weight heparin nonvalvular atrial fibrillation (NVAF) and stroke prevention. The green cluster consists of pharmacokinetics pharmacodynamics venous thromboembolism antithrombotic therapy anticoagulant warfarin atrial fibrillation stoke pulmonary embolism (PE). The keywords of the yellow cluster are mainly apixaban direct oral anticoagulants rivaroxaban dabigatran bleeding edoxaban efficacy risk management safety and vitamin K antagonist.

Discussion

General Information

This study examines the characteristics of articles related to AF and VTE over the last 20 years to describe the current state of this research field and to help guide future research. Overall, within the last 20 years, the number of published studies on AF and VTE has been increasing year by year and will continue to increase in the future.

As shown in Figure 2, only 18 articles were published in 2003, suggesting that researchers were just becoming aware of the association between AF and VTE. After 2012, the annual number of published articles reached over 100; especially after 2017, the annual number of published articles increased sharply to >200. In addition, the citation frequency of articles also shows an increasing trend year by year, suggesting that AF and VTE is a new hot research field. In terms of the overall trend, the number of published articles did not show an obvious fault‐line increase, but an overall steady growth trend instead. This indicates that the increase in the number of articles is not dependent on the unilateral increase of AF or VTE, and it is more likely that scientists are focusing on the association between AF and VTE. In recent years, research in related fields has shifted from AF triggering VTE and VTE promoting the occurrence of AF, to the 2‐way relationship between VTE and AF.

Visual analysis of the distribution of countries and institutions revealed that the United States published the most articles on AF and VTE, more than 3 times as many as Canada, the second‐highest country. McMaster University is the institution that has published the most articles in this field. Professor Gregory Y.H. Lip from the Research Center of Cardiovascular Science, University of Birmingham, UK, is the author who has published the most articles in this field, 59 in total. Keyword analysis shows that anticoagulants such as warfarin and novel oral anticoagulants (NOACs) are the core of AF and VTE research. Of the 761 academic journals that have published articles related to AF and VTE, Thrombosis Research was the most published journal. The dual‐map overlay of journals shows the theme distribution of the academic journals. It can be seen from the 2 main approaches in Figure 5 that the research on AF and VTE has gradually transformed from basic research to clinical research.

The analysis of the distribution of institutions shows that among the top 10 institutions, only 3 institutions have a centrality >0.1, indicating that the cooperation and communication between institutions are very poor, which may seriously hinder the research development in this field. Author's collaboration network analysis provides information on influential research teams and potential collaborators, helping to analyze collaborative relationships between them. As shown in Table S3, the top 10 authors of AF and VTE are potential collaborators, and reading their publications is helpful to understand the knowledge structure in this field. However, only 3 of the top 10 authors have a centrality >0.1, suggesting a lack of communication and collaboration among authors. Therefore, it is strongly recommended that countries, institutions, and authors eliminate academic barriers, and establish cooperation and data exchange to promote the development and progress of research on AF and VTE.

The Hotspots and Frontiers

A Shift in Research Direction

Keyword analysis can help us understand the hot spots and frontiers in a certain field. As can be seen from Table S3, the keywords with high frequency were atrial fibrillation, venous thromboembolism, warfarin, FXaI, deep vein thrombosis, rivaroxaban, risk, antithrombotic therapy, prevention, dabigatran, oral anticoagulant, management, and stroke prevention, etc. Cluster analysis was carried out according to the keywords, and 3 clusters were finally formed. From 2002 to 2013, the key words focused on the clinical observation and meta‐analysis of the impact of antithrombotic therapy on mortality and bleeding in patients with AF, and preliminarily explored the risk factors and mechanisms of thrombosis and thrombosis complications in patients with AF. During this period, warfarin, a traditional anticoagulant, was the main antithrombotic drug. 2014 to 2016 was a period of rapid development in this field. The keywords during this period mainly focus on the pharmacodynamics and pharmacokinetics of NOACs such as dabigatran and FXaIs in the prevention of atrial fibrillation thrombus, as well as the randomized double‐blind clinical trials of antithrombotic therapy in stroke and deep vein and knee replacement surgery. Since 2017, research in this field has been expanded significantly. The number of papers published each year has remained over 200. The key words mainly focus on the clinical efficacy and safety of NOACs. These studies are usually compared with the traditional anticoagulant vitamin K antagonists. In addition to the fact that warfarin is still preferred for valvular atrial fibrillation, the efficacy and safety of NOACs are better than those of traditional anticoagulants, and this priority was written into the guidelines 9 and has been widely recognized.

Evolution of the Relationship Between AF and VTE

The relationship between AF and VTE is a gradually changing cognitive process. Early studies reported that AF incidence in patients with acute PE was 15% to 21%. 10 , 11 , 12 The Tromsø study 13 in 2014 studied the risk of VTE in patients with AF. This study included 29 975 subjects, with a median follow‐up time of 16 years, and concluded that AF was associated with an increased risk of VTE, especially PE. Furthermore, their results support that isolated PE may result from right atrial thrombosis caused by AF. Lutsey et al. 8 found that the relationship between AF and VTE may be bidirectional. They found that patients with AF have roughly twice the risk of being diagnosed with occasional VTE, while patients with VTE have approximately twice the risk of being diagnosed with AF. Scientists found that the mechanism of PE‐inducing AF may be caused by blocking the pulmonary artery, increasing pulmonary vascular resistance and right ventricular afterload, and releasing vasoconstrictor and inflammatory cytokines. 5 , 14 , 15 These factors lead to an increase of right atrial pressure and strain, which leads to atrial fibrillation. A large cohort study found that patients with AF with VTE were associated with an increased risk of severe lower extremity events, systemic thromboembolism, and death. 16 Although the focus of anticoagulant therapy in patients with AF is to prevent stroke and systemic embolism, there may be other benefits in preventing VTE. This is particularly important because VTE mainly occurs in the elderly and patients with complications, and comprehensive evidence from pathophysiological and epidemiological studies supports that AF is a potential risk factor for VTE. 3 , 5 , 13 More specifically, AF leads to PE through right atrial thrombosis or VTE through concomitant procoagulant status. 17 , 18 The 2‐way relationship between AF and VTE suggests that anticoagulation therapy in patients with NVAF is likely to reduce the additional risk of VTE, because OACs have been proven to be available for the secondary prevention of VTE. 19 , 20 Although there is no prospective study on the relationship between AF and VTE, these findings highlight groups of patients who may be at an increased risk of AF and VTE, and prevention strategies should be developed for these groups. Since there is currently no treatment plan for their comorbidity, it is of great significance to carry out relevant research. At the same time, it also suggests that our guidelines for oral anticoagulation to prevent stroke in patients with AF 9 may be beneficial to VTE protection, while anticoagulation to prevent the recurrence of VTE 21 can provide additional protection for AF. 5

Development and Changes of Anticoagulant Drugs

Anticoagulant therapy is an important part in the treatment of VTE and the prevention of stroke in patients with AF. The use of anticoagulants for antithrombotic prevention can reduce the incidence and mortality of symptomatic and asymptomatic VTE in at‐risk patients. 22 Anticoagulant therapy reduced the incidence of death and embolism in patients with AF and reduced the mortality and recurrence in patients with VTE. 23 , 24 According to the evolution of keywords, the traditional oral anticoagulant warfarin was the main preventive agent for stroke in patients with AF, as well as the main drug for VTE treatment and secondary prevention before 2010. Warfarin has been the dominant oral anticoagulant for the treatment of VTE and the prevention of stroke in NVAF for half a century since its formal approval for human use in 1954. While warfarin reduces the risk of thromboembolic complications in AF and VTE, it also has a narrow treatment window and interacts with numerous foods and drugs that require frequent INR monitoring, which weaken its efficacy and patients' compliance. These shortcomings of warfarin have driven the development of NOACs that have similar anticoagulant efficacy as warfarin with a broader treatment range, and do not require continuous monitoring.

In 2010, the US Food and Drug Administration approved the first NOAC, dabigatran, for human application. Currently, 4 NOACs including dabigatran, rivaroxaban, apixaban, and edoxaban have been approved for clinical application, which expands the options for human application of OAC. Compared with warfarin, NOACs has more stable pharmacokinetics, more predictable anticoagulation, fewer drug–food interactions, the same or better effect on reducing mortality and vascular complications, and lower incidence of intracranial hemorrhage. 25 , 26 In 4 randomized trials 27 , 28 , 29 , 30 involving 71 683 patients with AF, NOACs were tested as a substitute for warfarin and it was concluded that compared with warfarin, NOAC significantly reduced stroke or systemic embolism by 19%, massive hemorrhage by 14%, fatal hemorrhage by 51%, and mortality by 10%. 31 , 32 Since their development, NOACs have had a series of efficacy and safety studies conducted and are gradually recommended as the first‐choice drug for VTE treatment and NVAF stroke prevention by the guidelines. Rivaroxaban, 33 apixaban, 34 and dabigatran 35 were approved for the prevention of VTE after orthopedic surgery in 2010 to 2012. Large randomized clinical trials have shown that NOACs dabigatran, 27 rivaroxaban, 28 apixaban, 29 and edoxaban 30 are as effective as warfarin in preventing stroke and cardiac embolism complications in patients with NVAF. Studies of different kinds of NOACs in the treatment of AF and VTE with different doses concluded that the dose adjustment is mainly related to AF and should not be used in the treatment of acute VTE. Conversely, low‐intensity NOAC can be used to study and approve the primary or secondary indications for prevention of VTE. 36

2010 to 2017 was a period featuring advanced clinical development in the treatment of acute, long‐term, and prolonged phases for AF and VTE with new oral medications. In 2014, the guidelines issued by the American Heart Association/American College of Cardiology/Heart Rhythm Society proposed warfarin and NOACs to prevent stroke in AF, but it was not recommended to prescribe both. 37 In 2020, the guidelines recommended that NOACs be superior to warfarin as the first‐choice drug for stroke prevention in patients with AF. 9 In January 2016, the American College of Chest Physicians recommended that NOACs be superior to warfarin as the first‐choice drug for the treatment of non‐cancer‐related VTE. 21 , 38 Since 2017, relevant research has been carried out around the application of NOACs to vulnerable populations, such as the elderly or obese people, and positive feedback has also been obtained. Sharma et al 39 conducted a meta‐analysis of 19 large multicenter randomized controlled studies, comparing the efficacy and safety of elderly patients taking NOACs and warfarin in the treatment of AF and VTE. It was concluded that the efficacy of NOACs in the risk management of thrombosis in the elderly is at least equivalent to warfarin. Several high‐quality studies have compared the efficacy and safety of NOACs with warfarin in patients with AF and VTE and who have high body weight and high body mass index and concluded that NOACs are safe and effective in the treatment of AF or VTE in extreme‐weight patients when compared with warfarin. 40 , 41

In addition, despite the relative risk reduction, the total risk of massive hemorrhage was as high as 3% per year in patients with AF, which is still an unacceptably high level. 42 The US Food and Drug Administration approved andexanet alfa (AndexXa) as a reversal agent for the FXaIs, rivaroxaban (Xarelto) and apixaban (Eliquis), in May 2018. Idarucizumab is an inhibitor of dabigatran, which was used in patients with major bleeding or in need of urgent surgery. For major bleeding on FXaIs, AndexXa has been proved to be a most effective and safe reversal. 43 The universal reversal agent, ciraparantag, remains under development and may be a potential broad‐spectrum reversal agent.

In general, the recommended anticoagulant drugs for AF and VTE have gradually evolved from warfarin priority to NOACs. With further research, the application of NOACs is gradually expanding, but warfarin is still recommended for patients with valvular atrial fibrillation and mechanical valve replacement.

Strengths and Limitations

This literature analysis based on visualization can provide a direction for scholars to quickly understand the research focus and development trends of AF and VTE in cardiovascular science. To our knowledge, this is the first bibliometric analysis of AF and VTE. The visual analysis of the literature provides a channel for researchers to comprehend the research topics, hotspots, and development trends in the field of AF and VTE. However, this study also has some limitations that need to be addressed. First, this study only searched the literatures in the Web of Science Core Collection database. Although Science Net is one of the most authoritative scientific and technological literature retrieval tools, it cannot cover all the research of AF and VTE. Second, due to the limitations of the extraction period, the literature information of 2022 has not been completely included.

Conclusions

AF and VTE have important research value and application prospects in cardiovascular science. According to the results of visual analysis conducted by CiteSpace and VOSviewer software, the research on AF and VTE is expanding rapidly. An increasing number of articles have been published in international core journals, indicating a significant impact. The United States and Canada are the leading countries in terms of research; however, a lack of cooperation between countries and institutions is restricting progress in this field. Therefore, more cooperation and data exchange among institutions and scholars are needed to improve the research progress in this field.

Sources of Funding

This work was supported by the National Natural Science Foundation of China (No. 82174214), Fundamental Research Funds for the Central Public Welfare Research Institutes (No. ZZ15‐YQ‐003), and Scientific Fund of National Clinical Research Center for Chinese Medicine Cardiology (No. CMC2022004).

Disclosures

The authors report no conflicts of interest in this work.

Supporting information

Data S1

Tables S1–S3

Figures S1–S3

Acknowledgments

JG and DS: conceptualization and supervision. LM, CZ, and LS: data management, data analysis, methodology, software application, and writing (initial manuscript). JS and HY: writing (review and editing).

This manuscript was sent to Luciano A. Sposato, MD, MBA, Associate Editor, for review by expert referees, editorial decision, and final disposition.

For Sources of Funding and Disclosures, see page 10.

Contributor Information

Dazhuo Shi, Email: shidztcm@163.com.

Jie Gao, Email: gaojie_enjoylife@163.com.

References

  • 1. Baman JR, Passman RS. Atrial fibrillation. JAMA. 2021;325:2218. doi: 10.1001/jama.2020.23700 [DOI] [PubMed] [Google Scholar]
  • 2. Noel P, Gregoire F, Capon A, Lehert P. Atrial fibrillation as a risk factor for deep venous thrombosis and pulmonary emboli in stroke patients. Stroke. 1991;22:760–762. doi: 10.1161/01.STR.22.6.760 [DOI] [PubMed] [Google Scholar]
  • 3. Wang CC, Lin CL, Wang GJ, Chang CT, Sung FC, Kao CH. Atrial fibrillation associated with increased risk of venous thromboembolism. A population‐based cohort study. Thromb Haemost. 2015;113:185–192. doi: 10.1160/TH14-05-0405 [DOI] [PubMed] [Google Scholar]
  • 4. Sundbøll J, Hováth‐Puhó E, Adelborg K, Ording A, Schmidt M, Bøtker HE, Sørensen HT. Risk of arterial and venous thromboembolism in patients with atrial fibrillation or flutter: a nationwide population‐based cohort study. Int J Cardiol. 2017;241:182–187. doi: 10.1016/j.ijcard.2017.04.081 [DOI] [PubMed] [Google Scholar]
  • 5. Bikdeli B, Abou Ziki MD, Lip GYH. Pulmonary embolism and atrial fibrillation: two sides of the same coin? A systematic review. Semin Thromb Hemost. 2017;43:849–863. doi: 10.1055/s-0036-1598005 [DOI] [PubMed] [Google Scholar]
  • 6. Hald EM, Enga KF, Løchen ML, Mathiesen EB, Njølstad I, Wilsgaard T, Braekkan SK, Hansen JB. Venous thromboembolism increases the risk of atrial fibrillation: the Tromso study. J Am Heart Assoc. 2014;3:e000483. doi: 10.1161/JAHA.113.000483 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7. Ng AC, Adikari D, Yuan D, Lau JK, Yong AS, Chow V, Kritharides L. The prevalence and incidence of atrial fibrillation in patients with acute pulmonary embolism. PLoS One. 2016;11:e0150448. doi: 10.1371/journal.pone.0150448 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8. Lutsey PL, Norby FL, Alonso A, Cushman M, Chen LY, Michos ED, Folsom AR. Atrial fibrillation and venous thromboembolism: evidence of bidirectionality in the Atherosclerosis Risk in Communities Study. J Thromb Haemost. 2018;16:670–679. doi: 10.1111/jth.13974 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström‐Lundqvist C, Boriani G, Castella M, Gheorghe‐Andrei D, Dilaveris PE, et al. ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio‐Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2020;2021(42):373–498. doi: 10.1093/eurheartj/ehaa612 [DOI] [PubMed] [Google Scholar]
  • 10. Koracevic G, Atanaskovic V. Is atrial fibrillation a prognosticator in acute pulmonary thromboembolism? Med Princ Pract. 2010;19:166. doi: 10.1159/000273082 [DOI] [PubMed] [Google Scholar]
  • 11. Kukla P, Długopolski R, Krupa E, Furtak R, Szełemej R, Mirek‐Bryniarska E, Jastrzębski M, Nowak J, Waęczura P, Bryniarski L. Electrocardiography and prognosis of patients with acute pulmonary embolism. Cardiol J. 2011;18:648–653. doi: 10.5603/CJ.2011.0028 [DOI] [PubMed] [Google Scholar]
  • 12. Barra SN, Paiva LV, Providência R, Fernandes A, Leitão MA. Atrial fibrillation in acute pulmonary embolism: prognostic considerations. Emerg Med J. 2014;31:308–312. doi: 10.1136/emermed-2012-202089 [DOI] [PubMed] [Google Scholar]
  • 13. Enga KF, Rye‐Holmboe I, Hald EM, Løchen ML, Mathiesen EB, Njølstad I, Wilsgaard T, Braekkan SK, Hansen J‐B. Atrial fibrillation and future risk of venous thromboembolism:the Tromsø study. J Thromb Haemost. 2015;13:10–16. doi: 10.1111/jth.12762 [DOI] [PubMed] [Google Scholar]
  • 14. Gex G, Gerstel E, Righini M, LE Gal G, Aujesky D, Roy PM, Sanchez O, Verschuren F, Rutschmann OT, Perneger T, et al. Is atrial fibrillation associated with pulmonary embolism? J Thromb Haemost. 2012;10:347–351. doi: 10.1111/j.1538-7836.2011.04608.x [DOI] [PubMed] [Google Scholar]
  • 15. Matthews JC, McLaughlin V. Acute right ventricular failure in the setting of acute pulmonary embolism or chronic pulmonary hypertension: a detailed review of the pathophysiology, diagnosis, and management. Curr Cardiol Rev. 2008;4:49–59. doi: 10.2174/157340308783565384 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16. Lin MS, Chung CM, Chen MY, Chu PH, Chang ST, Yang TY, Wu VC, Lin WY, Lin YS. Venous thromboembolism and critical limb events in patients with atrial fibrillation: a nationwide population‐based cohort study. Angiology. 2022;73:413–421. doi: 10.1177/00033197211033747 [DOI] [PubMed] [Google Scholar]
  • 17. Watson T, Shantsila E, Lip GY. Mechanisms of thrombogenesis in atrial fibrillation: Virchow's triad revisited. Lancet. 2009;373:155–166. doi: 10.1016/S0140-6736(09)60040-4 [DOI] [PubMed] [Google Scholar]
  • 18. Iwasaki YK, Nishida K, Kato T, Nattel S. Atrial fibrillation pathophysiology: implications for management. Circulation. 2011;124:2264–2274. doi: 10.1161/CIRCULATIONAHA.111.019893 [DOI] [PubMed] [Google Scholar]
  • 19. Ridker PM, Goldhaber SZ, Danielson E, Rosenberg Y, Eby CS, Deitcher SR, Cushman M, Moll S, Kessler CM, Elliott CG. Long‐term, low‐intensity warfarin therapy for the prevention of recurrent venous thromboembolism. N Engl J Med. 2003;348:1425–1434. doi: 10.1056/NEJMoa035029 [DOI] [PubMed] [Google Scholar]
  • 20. Kearon C, Ginsberg JS, Kovacs MJ, Anderson DR, Wells P, Julian JA, MacKinnon B, Weitz JI, Crowther MA, Dolan S, et al. Comparison of low‐intensity warfarin therapy with conventional‐intensity warfarin therapy for long‐term prevention of recurrent venous thromboembolism. N Engl J Med. 2003;349:631–639. doi: 10.1056/NEJMoa035422 [DOI] [PubMed] [Google Scholar]
  • 21. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, Huisman M, King CS, Morris TA, Sood N, et al. Antithrombotic therapy for vte disease: chest guideline and expert panel report. Chest. 2016;149:315–352. doi: 10.1016/j.chest.2015.11.026 [DOI] [PubMed] [Google Scholar]
  • 22. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW. Prevention of venous thromboembolism: American College of Chest Physicians Evidence‐Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:381s–453s. doi: 10.1378/chest.08-0656 [DOI] [PubMed] [Google Scholar]
  • 23. Singer DE, Albers GW, Dalen JE, Fang MC, Go AS, Halperin JL, Lip GYH, Manning WJ. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence‐Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:546s–592s. doi: 10.1378/chest.08-0678 [DOI] [PubMed] [Google Scholar]
  • 24. Bates SM, Greer IA, Pabinger I, Sofaer S, Hirsh J. Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence‐Based Clinical Practice Guidelines (8th edition). Chest. 2008;133:844s–886s. doi: 10.1378/chest.08-0761 [DOI] [PubMed] [Google Scholar]
  • 25. Adam SS, McDuffie JR, Ortel TL, Williams JW Jr. Comparative effectiveness of warfarin and new oral anticoagulants for the management of atrial fibrillation and venous thromboembolism: a systematic review. Ann Intern Med. 2012;157:796–807. doi: 10.7326/0003-4819-157-10-201211200-00532 [DOI] [PubMed] [Google Scholar]
  • 26. Yao X, Abraham NS, Sangaralingham LR, Bellolio MF, McBane RD, Shah ND, Noseworthy PA. Effectiveness and safety of dabigatran, rivaroxaban, and apixaban versus warfarin in nonvalvular atrial fibrillation. J Am Heart Assoc. 2016;5:5. doi: 10.1161/JAHA.116.003725 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–1151. doi: 10.1056/NEJMoa0905561 [DOI] [PubMed] [Google Scholar]
  • 28. Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, Breithardt G, Halperin JL, Hankey GJ, Piccini JP. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–891. doi: 10.1056/NEJMoa1009638 [DOI] [PubMed] [Google Scholar]
  • 29. Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, Al‐Khalidi HR, Ansell J, Atar D, Avezum A, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–992. doi: 10.1056/NEJMoa1107039 [DOI] [PubMed] [Google Scholar]
  • 30. Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL, Waldo AL, Ezekowitz MD, Weitz JI, Špinar J, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–2104. doi: 10.1056/NEJMoa1310907 [DOI] [PubMed] [Google Scholar]
  • 31. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta‐analysis of randomised trials. Lancet. 2014;383:955–962. doi: 10.1016/S0140-6736(13)62343-0 [DOI] [PubMed] [Google Scholar]
  • 32. Gómez‐Outes A, Lagunar‐Ruíz J, Terleira‐Fernández AI, Calvo‐Rojas G, Suárez‐Gea ML, Vargas‐Castrillón E. Causes of death in anticoagulated patients with atrial fibrillation. J Am Coll Cardiol. 2016;68:2508–2521. doi: 10.1016/j.jacc.2016.09.944 [DOI] [PubMed] [Google Scholar]
  • 33. Turpie AG, Lassen MR, Eriksson BI, Gent M, Berkowitz SD, Misselwitz F, Bandel TJ, Homering M, Westermeier T, Kakkar AK. Rivaroxaban for the prevention of venous thromboembolism after hip or knee arthroplasty. Pooled analysis of four studies. Thromb Haemost. 2011;105:444–453. doi: 10.1160/TH10-09-0601 [DOI] [PubMed] [Google Scholar]
  • 34. Huang J, Cao Y, Liao C, Wu L, Gao F. Apixaban versus enoxaparin in patients with total knee arthroplasty. A meta‐analysis of randomised trials. Thromb Haemost. 2011;105:245–253. doi: 10.1160/TH10-08-0552 [DOI] [PubMed] [Google Scholar]
  • 35. Wolowacz SE, Roskell NS, Plumb JM, Caprini JA, Eriksson BI. Efficacy and safety of dabigatran etexilate for the prevention of venous thromboembolism following total hip or knee arthroplasty. A meta‐analysis. Thromb Haemost. 2009;101:77–85. doi: 10.1160/TH08-07-0493 [DOI] [PubMed] [Google Scholar]
  • 36. Bikdeli B, Zahedi Tajrishi F, Sadeghipour P, Talasaz AH, Fanikos J, Lippi G, Siegal DM, Eikelboom JW, Monreal M, Jimenez D, et al. Efficacy and safety considerations with dose‐reduced direct oral anticoagulants: a review. JAMA Cardiol. 2022;7:747–759. doi: 10.1001/jamacardio.2022.1292 [DOI] [PubMed] [Google Scholar]
  • 37. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2014;130:e199–e267. doi: 10.1161/CIR.0000000000000041 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38. Ansell JE. Management of venous thromboembolism: clinical guidance from the Anticoagulation Forum. J Thromb Thrombolysis. 2016;41:1–2. doi: 10.1007/s11239-015-1320-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39. Sharma M, Cornelius VR, Patel JP, Davies JG, Molokhia M. Efficacy and harms of direct oral anticoagulants in the elderly for stroke prevention in atrial fibrillation and secondary prevention of venous thromboembolism: systematic review and meta‐analysis. Circulation. 2015;132:194–204. doi: 10.1161/CIRCULATIONAHA.114.013267 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40. Novak AR, Shakowski C, Trujillo TC, Wright GC, Mueller SW, Kiser TH. Evaluation of safety and efficacy outcomes of direct oral anticoagulants versus warfarin in normal and extreme body weights for the treatment of atrial fibrillation or venous thromboembolism. J Thromb Thrombolysis. 2022;54:276–286. doi: 10.1007/s11239-022-02668-8 [DOI] [PubMed] [Google Scholar]
  • 41. Perales IJ, San Agustin K, DeAngelo J, Campbell AM. Rivaroxaban versus warfarin for stroke prevention and venous thromboembolism treatment in extreme obesity and high body weight. Ann Pharmacother. 2020;54:344–350. doi: 10.1177/1060028019886092 [DOI] [PubMed] [Google Scholar]
  • 42. Gonsalves WI, Pruthi RK, Patnaik MM. The new oral anticoagulants in clinical practice. Mayo Clin Proc. 2013;88:495–511. doi: 10.1016/j.mayocp.2013.03.006 [DOI] [PubMed] [Google Scholar]
  • 43. Milling TJ Jr, Ziebell CM. A review of oral anticoagulants, old and new, in major bleeding and the need for urgent surgery. Trends Cardiovasc Med. 2020;30:86–90. doi: 10.1016/j.tcm.2019.03.004 [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Data S1

Tables S1–S3

Figures S1–S3


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