Evidence map›Paper›PMID 22315273›Full record

GuidelineChest2012

Antithrombotic and thrombolytic therapy for ischemic stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Maarten G Lansberg, Martin J O'Donnell, Pooja Khatri, Eddy S Lang, Mai N Nguyen-Huynh, Neil E Schwartz, Frank A Sonnenberg, Sam Schulman, Per Olav Vandvik, Frederick A Spencer and 3 more

Open access · bronzeAbstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 158 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
158citing papers in PubMed, 15 pooled it
36.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

158 citing papers in PubMed, 15 syntheses or guidelines pooled it, 449 citations in OpenAlex.

  1. Pooled it
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  3. A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization.International journal of stroke : official journal of the International Stroke Society · 2023
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  8. Guideline
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  16. Trial
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  18. Article
  19. Management of symptomatic vertebrobasilar dissection: What is the current role for endovascular therapy and stents?Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026
    Article
  20. Article

98 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 10 institutions in 5 countries.

Maarten G LansbergStanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA.
Martin J O'DonnellHRB-Clinical Research Faculty, National University of Ireland Galway, Galway, Ireland.
Pooja KhatriDepartment of Neurology, University of Cincinnati, Cincinnati, OH.
Eddy S LangUniversity of Calgary, Calgary, AB, Canada.
Mai N Nguyen-HuynhDepartment of Neurology, University of California, San Francisco, CA.
Neil E SchwartzStanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA.
Frank A SonnenbergDivision of General Internal Medicine, UMDNJ/Robert Wood Johnson Medical School, New Brunswick, NJ.
Sam SchulmanDepartment of Medicine, McMaster University, ON, Canada.
Per Olav VandvikNorwegian Knowledge Centre for the Health Services, Oslo, Norway.
Frederick A SpencerSt. Joseph's Healthcare, Hamilton, ON, Canada.
Pablo Alonso-CoelloIberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain.
Gordon H GuyattDepartment of Medicine, McMaster University, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Elie A AklState University of New York at Buffalo, Buffalo, NY; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Electronic address: elieakl@buffalo.edu.
McMaster University · CAStanford University · USIberoamerican Cochrane Centre · ESJohnson University · USNasjonalt Kunnskapssenter for Helsetjenesten · NOOllscoil na Gaillimhe – University of Galway · IESt. Joseph’s Healthcare Hamilton · CAUniversity of Calgary · CAUniversity of California, San Francisco · USUniversity of Cincinnati · US

Funding

Antithrombotic Therapy and Prevention of Thrombosis: ACCP Evidence-Based ClinicalR13HL104758 · NHLBI · AMERICAN COLLEGE OF CHEST PHYSICIANS · PI LEWIS, SANDRA ZELMAN · 2010 to 2010
$11k
NHLBI NIH HHS R13 HL104758
6 · The paper itself

Abstract

objectivesThis article provides recommendations on the use of antithrombotic therapy in patients with stroke or transient ischemic attack (TIA).

methodsWe generated treatment recommendations (Grade 1) and suggestions (Grade 2) based on high (A), moderate (B), and low (C) quality evidence.

resultsIn patients with acute ischemic stroke, we recommend IV recombinant tissue plasminogen activator (r-tPA) if treatment can be initiated within 3 h (Grade 1A) or 4.5 h (Grade 2C) of symptom onset; we suggest intraarterial r-tPA in patients ineligible for IV tPA if treatment can be initiated within 6 h (Grade 2C); we suggest against the use of mechanical thrombectomy (Grade 2C) although carefully selected patients may choose this intervention; and we recommend early aspirin therapy at a dose of 160 to 325 mg (Grade 1A). In patients with acute stroke and restricted mobility, we suggest the use of prophylactic-dose heparin or intermittent pneumatic compression devices (Grade 2B) and suggest against the use of elastic compression stockings (Grade 2B). In patients with a history of noncardioembolic ischemic stroke or TIA, we recommend long-term treatment with aspirin (75-100 mg once daily), clopidogrel (75 mg once daily), aspirin/extended release dipyridamole (25 mg/200 mg bid), or cilostazol (100 mg bid) over no antiplatelet therapy (Grade 1A), oral anticoagulants (Grade 1B), the combination of clopidogrel plus aspirin (Grade 1B), or triflusal (Grade 2B). Of the recommended antiplatelet regimens, we suggest clopidogrel or aspirin/extended-release dipyridamole over aspirin (Grade 2B) or cilostazol (Grade 2C). In patients with a history of stroke or TIA and atrial fibrillation we recommend oral anticoagulation over no antithrombotic therapy, aspirin, and combination therapy with aspirin and clopidogrel (Grade 1B).

conclusionsThese recommendations can help clinicians make evidence-based treatment decisions with their patients who have had strokes.

Indexed as

Evidence-Based MedicineSocieties, MedicalThrombolytic TherapyAspirinCombined Modality TherapyDose-Response Relationship, DrugDrug Therapy, CombinationFibrinolytic AgentsHeparinHumansIntermittent Pneumatic Compression DevicesIntracranial ThrombosisIschemic Attack, TransientPlatelet Aggregation InhibitorsRecombinant ProteinsStrokeAspirinFibrinolytic AgentsHeparinPlatelet Aggregation InhibitorsRecombinant ProteinsTissue Plasminogen Activator

Identifiers

PMID22315273
PMCPMC3278065
OpenAlexW2141913785

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.