{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:21:26Z","timestamp":1791037286129,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anemia is frequently observed as a comorbidity in atrial fibrillation (AF), especially in elderly patients and in those on anticoagulation. This has been associated with poor clinical outcomes. We aim to investigate the impact of anemia on clinical outcomes in patients with AF on oral anticoagulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We comprehensively searched PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through March 2024 and conducted a prognostic systematic review and meta\u2010analysis. All analyses were performed using R V. 4.3.1. This meta\u2010analysis was registered at PROSPERO (CRD42024556023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 23 studies comprising 286,781 patients for analysis. Anemia had a significant association with an 84% increase in risk of major bleeding (HR: 1.84 with 95% CI [1.59, 2.13], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), a 32% increase in the risk of intracranial hemorrhage (HR: 1.32 with 95% CI [1.10, 1.58], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), a 98% increase in the risk of gastrointestinal bleeding (HR: 1.98 with 95% CI [1.67, 2.35], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and a 91% increase in the risk of all\u2010cause mortality (HR: 1.91 with 95% CI [1.46, 2.51], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). However, the impact of anemia did not significantly affect the risk of stroke, transient ischemic stroke (TIA), or systemic embolism (HR: 1.07 with 95% CI [0.93, 1.22], <jats:italic>p<\/jats:italic>\u2009=\u20090.36).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Anemia was significantly associated with an increased risk of major bleeding, intracranial hemorrhage, gastrointestinal bleeding, and all\u2010cause mortality. However, anemia did not significantly impact stroke, TIA, or systemic embolism.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16537","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T05:31:03Z","timestamp":1735018263000},"page":"430-448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of Anemia on Clinical Outcomes in Atrial Fibrillation Patients on Oral Anticoagulants: A Prognostic Meta\u2010Analysis"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2687-3880","authenticated-orcid":false,"given":"Ahmed Mazen","family":"Amin","sequence":"first","affiliation":[{"name":"Faculty of Medicine Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8334-697X","authenticated-orcid":false,"given":"Hossam","family":"Elbenawi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3423-4055","authenticated-orcid":false,"given":"Ramez M.","family":"Odat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Jordan University of Science and Technology Irbid Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-6997","authenticated-orcid":false,"given":"Mohamed","family":"Elgebaly","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4298-5456","authenticated-orcid":false,"given":"Ali Saad","family":"Al\u2010shammari","sequence":"additional","affiliation":[{"name":"College of Medicine University of Baghdad Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6266-4991","authenticated-orcid":false,"given":"AlMothana","family":"Manasrah","sequence":"additional","affiliation":[{"name":"Internal Medicine Department UHS\u2010Wilson Medical Center Binghamton New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8016-9679","authenticated-orcid":false,"given":"Michael","family":"Nakhla","sequence":"additional","affiliation":[{"name":"Internal Medicine Department Saint Vincent Hospital Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2007-937X","authenticated-orcid":false,"given":"Dina","family":"Ayman","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beni\u2010Suef University Beni Suef Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8142-8073","authenticated-orcid":false,"given":"Mohamed Ahmed","family":"Ali","sequence":"additional","affiliation":[{"name":"Qena Faculty of Medicine South Valley University Qena Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7180-5204","authenticated-orcid":false,"given":"Ahmed","family":"Helmi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2514-0689","authenticated-orcid":false,"given":"Mohamed","family":"Abuelazm","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tanta University Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8389-2574","authenticated-orcid":false,"given":"Caique M. 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