Evidence map›Paper›PMID 25908460›Full record

Trial reportStroke2015

Left atrial enlargement and stroke recurrence: the Northern Manhattan Stroke Study.

Shadi Yaghi, Yeseon P Moon, Consuelo Mora-McLaughlin, Joshua Z Willey, Ken Cheung, Marco R Di Tullio, Shunichi Homma, Hooman Kamel, Ralph L Sacco, Mitchell S V Elkind

2 registry-linked trialsOpen access · greenAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 112 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 3 pooled it
14.2field-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.

NCT03192215 phase3terminatednot on this mapstarted 2018, after this paper: background citation

AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke

TypeinterventionalSponsorColumbia UniversityRan2018 to 2023Enrolled1,015ConditionsStrokeArmsApixaban, Aspirin
NCT06589700 narecruitingnot on this mapstarted 2025, after this paper: background citation

Evolution of Burden of AF Biomarkers, Left Atrial Characteristics, Demographics,and Risk Factors in AF Detected After Stroke

TypeinterventionalSponsorLuciano A. SposatoRan2025 to 2027Enrolled24ConditionsStroke, Atrial FibrillationArmsImplantable Loop Recorder
3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 3 syntheses or guidelines pooled it, 212 citations in OpenAlex.

  1. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Guideline
  2. Pooled it
  3. Pooled it
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  10. Beyond CHAAnnals of biomedical engineering · 2026
    Article
  11. De-risking Atrial Fibrillation: Refining Anticoagulation Decision-Making.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026
    Review
  12. Left atrial cardiomyopathy: association with atrial fibrillation and stroke recurrence.The international journal of cardiovascular imaging · 2026
    Article
  13. Article
  14. Electrocardiographic Indicators of Left Atrial Remodeling in Ischemic Stroke Patients with Atrial Fibrillation.Medical science monitor : international medical journal of experimental and clinical research · 2025
    Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Cardiac Findings Following Cerebrovascular Disease.Journal of the American Heart Association · 2024
    Article

52 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

10 authors at 1 institution in 1 country.

Shadi YaghiFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.). shadiyaghi@yahoo.com.
Yeseon P MoonFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Consuelo Mora-McLaughlinFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Joshua Z WilleyFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Ken CheungFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Marco R Di TullioFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Shunichi HommaFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Hooman KamelFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Ralph L SaccoFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Mitchell S V ElkindFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., Y.P.M., C.M.-M.L., J.Z.W., M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (K.C.), Department of Internal Medicine, College of Physicians and Surgeons (M.R.D.T., S.H.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); and Departments of Neurology, Public Health Sciences, Human Genetics, and Neurosurgery, Miller School of Medicine, University of Miami, FL (R.L.S.).
Cornell University · US

Funding

STROKE INCIDENCE AND RISK FACTORS IN A TRI-ETHNIC REGIONR01NS029993 · NINDS · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI ELKIND, MITCHELL S, SACCO, RALPH L. · 1993 to 2019
$19.2M
New York Stroke Trials Network of Columbia and Cornell (NYCCSTN)U10NS086728 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI MARSHALL, RANDOLPH S · 2013 to 2017
$2.0M
Atrial Fibrillation Precursors May Be Novel Stroke Risk FactorsK23NS082367 · NINDS · WEILL MEDICAL COLL OF CORNELL UNIV · PI KAMEL, HOOMAN · 2013 to 2017
$937k
NINDS NIH HHS K23 NS082367NINDS NIH HHS R01 NS029993NINDS NIH HHS U10 NS086728
6 · The paper itself

Abstract

background and purposeAlthough left atrial enlargement (LAE) increases incident stroke risk, the association with recurrent stroke is less clear. Our aim was to determine the association of LAE with recurrent stroke most likely related to embolism (cryptogenic and cardioembolic) and all ischemic stroke recurrences.

methodsWe followed 655 first ischemic stroke patients in the Northern Manhattan Stroke Study for ≤5 years. LA size from 2D echocardiography was categorized as normal LAE (52.7%), mild LAE (31.6%), and moderate-severe LAE (15.7%). We used Cox proportional hazard models to calculate the hazard ratios and 95% confidence intervals for the association of LA size and LAE with recurrent cryptogenic/cardioembolic and total recurrent ischemic stroke.

resultsLA size was available in 529 (81%) patients. Mean age at enrollment was 69±13 years; 45.8% were male, 54.0% Hispanic, and 18.5% had atrial fibrillation. Over a median of 4 years, there were 65 recurrent ischemic strokes (29 were cardioembolic or cryptogenic). In multivariable models adjusted for confounders, including atrial fibrillation and heart failure, moderate-severe LAE compared with normal LA size was associated with greater risk of recurrent cardioembolic/cryptogenic stroke (adjusted hazard ratio 2.83, 95% confidence interval 1.03-7.81), but not total ischemic stroke (adjusted hazard ratio 1.06, 95% confidence interval, 0.48-2.30). Mild LAE was not associated with recurrent stroke.

conclusionModerate to severe LAE was an independent marker of recurrent cardioembolic or cryptogenic stroke in a multiethnic cohort of ischemic stroke patients. Further research is needed to determine whether anticoagulant use may reduce risk of recurrence in ischemic stroke patients with moderate to severe LAE.

Indexed as

Atrial FibrillationCardiomegalyEchocardiographyModels, BiologicalStrokeAgedAged, 80 and overBrain IschemiaFemaleFollow-Up StudiesHeart AtriaHumansMaleMiddle AgedNew York CityRecurrenceembolism

Identifiers

PMID25908460
PMCPMC4442058
OpenAlexW2079630168

What OpenQuestion holds

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Registered trials

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.