Discontinuation and non-publication of atrial fibrillation clinical trials: A retrospective analysis of 538 trials

Authors

• Own Khraisat, Department of Medicine, Englewood Hospital and Medical Center, 350 Engle St., Englewood, NJ 07631, United States.
• Triston Messer, Hackensack Meridian School of Medicine, 123 Metro Blvd., Nutley, NJ 07110, United States.
• Khaled Harmouch, Department of Cardiology, University of Miami, 1600 NW 10th Ave., Ste. 1149, Miami, FL 33136, United States.
• Ahmad Alqaseer, Faculty of Medicine, Al-Balqa' Applied University, As-Salt, Jordan 19117.
• Waleed Ismail, Department of Internal Medicine, King Hussein Medical Center, Amman, Jordan 11733.
• Hashem Samardali, Department of Anesthesiology and Intensive Care Medicine, Catholic Hospital Bochum-St. Josef Hospital, Gudrunstrasse 56, 44791 Bochum, Germany.
• Ehab Alkhawaldeh, Department of Internal Medicine, Jameel Altotangi Hospital, Amman, Sahab 11511, Jordan.
• Amer Hammad, Department of Medicine, Banner University Medical Center, 1625 N. Campbell Ave., Tucson, AZ 85719, United States.
• Dipal Patel, Department of Medicine, Englewood Hospital and Medical Center, 350 Engle St., Englewood, NJ 07631, United States.
• Jason Sayanlar, Department of Cardiology, Englewood Hospital and Medical Center, 350 Engle St., Englewood, NJ 07631, United States.
• Muddasir Ashraf, Advocate Health - MidwestFollow
• Ahmad Khraisat, Advocate Health - MidwestFollow

Recommended Citation

Khraisat O, Messer T, Harmouch K, et al. Discontinuation and non-publication of atrial fibrillation clinical trials: A retrospective analysis of 538 trials. Int J Cardiol Heart Vasc. 2026;65:101949. Published 2026 Jun 8. doi:10.1016/j.ijcha.2026.101949

Affiliations

Aurora Sinai/Aurora St. Luke's Medical Centers

Abstract

Background: Atrial fibrillation (AF) clinical trials are essential for informing evidence-based care, yet many trials are discontinued or remain unpublished. This contributes to research inefficiency and reduced transparency. This study evaluated characteristics associated with discontinuation and non-publication of AF clinical trials registered on ClinicalTrials.gov.

Methods: We performed a retrospective analysis of interventional AF trials registered between 1999 and 2025 on ClinicalTrials.gov. Trials were categorized as completed or discontinued, and as published or unpublished. Trial characteristics were extracted, and multivariable logistic regression was used to identify predictors of discontinuation and non-publication.

Results: Among 538 AF trials, 423 trials (78.6 percent) were completed and 115 trials (21.4 percent) were discontinued. Only 153 trials (36.2 percent) were published. The estimated median time from primary completion to publication was 18.0 months (95% confidence interval, 14.0-21.0 months). Trials enrolling 100 participants or more had significantly lower odds of both discontinuation and non-publication. Multicenter trials showed higher odds of discontinuation but lower odds of non-publication. The other characteristics studied were not significant predictors.

Conclusions: A substantial proportion of AF trials are discontinued or remain unpublished, revealing ongoing gaps in research transparency. Larger sample sizes support higher completion and publication rates, while a multicenter design increases discontinuation risk but improves dissemination. These findings underscore the need for strategies that strengthen trial feasibility and reporting practices.

Type

Article

PubMed ID

42291445