Evidence map›Paper›PMID 25364886›Full record

SynthesisAnnals of internal medicine2014

Association between atrial fibrillation and silent cerebral infarctions: a systematic review and meta-analysis.

Shadi Kalantarian, Hakan Ay, Randy L Gollub, Hang Lee, Kallirroi Retzepi, Moussa Mansour, Jeremy N Ruskin

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
73citing papers in PubMed, 8 pooled it
6.5field-weighted citation impact, top 3% 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

73 citing papers in PubMed, 8 syntheses or guidelines pooled it, 160 citations in OpenAlex.

  1. Pooled it
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  6. Guideline
  7. The Association between Carotid Artery Atherosclerosis and Silent Brain Infarction: A Systematic Review and Meta-analysis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2017
    Pooled it
  8. Pooled it
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  10. Low rate of asymptomatic cerebral embolism and improved procedural efficiency with the novel pulmonary vein ablation catheter GOLD: results of the PRECISION GOLD trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2016
    Trial
  11. Heart-Brain Axis: Subclinical Cardiovascular Changes and Brain Health.Journal of the American Heart Association · 2026
    Review
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13 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

7 authors at 1 institution in 1 country.

Shadi Kalantarian
Hakan Ay
Randy L Gollub
Hang Lee
Kallirroi Retzepi
Moussa Mansour
Jeremy N Ruskin
Massachusetts General Hospital · US

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
NCRR NIH HHS UL1 RR 025758NCRR NIH HHS UL1 RR025758
6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) is a common cause of stroke. Silent cerebral infarctions (SCIs) are known to occur in the presence and absence of AF, but the association between these disorders has not been well-defined. PURPOSE: To estimate the association between AF and SCIs and the prevalence of SCIs in stroke-free patients with AF. DATA SOURCES: Searches of MEDLINE, PsycINFO, Cochrane Library, CINAHL, and EMBASE from inception to 8 May 2014 without language restrictions and manual screening of article references. STUDY SELECTION: Observational studies involving adults with AF and no clinical history of stroke or prosthetic valves who reported SCIs. DATA EXTRACTION: Study characteristics and study quality were assessed in duplicate. DATA SYNTHESIS: Eleven studies including 5317 patients with mean ages from 50.0 to 83.6 years reported on the association between AF and SCIs. Autopsy studies were heterogeneous and low-quality; therefore, they were excluded from the meta-analysis of the risk estimates. When computed tomography (CT) and magnetic resonance imaging (MRI) studies were combined, AF was associated with SCIs in patients with no history of symptomatic stroke (odds ratio, 2.62 [95% CI, 1.81 to 3.80]; I(2) = 32.12%; P for heterogeneity = 0.118). This association was independent of AF type (paroxysmal vs. persistent). The results were not altered significantly when the analysis was restricted to studies that met at least 70% of the maximum possible quality score (odds ratio, 3.06 [CI, 2.24 to 4.19]). Seventeen studies reported the prevalence of SCIs. The overall prevalence of SCI lesions on MRI and CT among patients with AF was 40% and 22%, respectively. LIMITATION: Most studies were cross-sectional, and autopsy studies were heterogeneous and not sufficiently sensitive to detect small lesions.

conclusionAtrial fibrillation is associated with more than a 2-fold increase in the odds for SCI. PRIMARY FUNDING SOURCE: Deane Institute for Integrative Research in Atrial Fibrillation and Stroke, Massachusetts General Hospital.

Indexed as

AgedAged, 80 and overAtrial FibrillationAutopsyCerebral InfarctionHumansMiddle AgedOdds RatioPrevalence

Identifiers

PMID25364886
PMCPMC5578742
OpenAlexW2000174880

What OpenQuestion holds

Textmetadata
LicenceTDM
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.