Evidence map›Paper›PMID 26187229›Full record

ReviewNeurology2015

Potential new uses of non-vitamin K antagonist oral anticoagulants to treat and prevent stroke.

Shadi Yaghi, Hooman Kamel, Mitchell S V Elkind

Registry-linked trialOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03192215 (AtRial Cardiopathy and Antithrombotic Drugs In Prevention After Cryptogenic Stroke), which is not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 20% 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
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Oral Anticoagulant and Antiplatelet Therapy for Cervical Artery Dissection: A Meta-Analysis of Clinical Trials.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  3. Article
  4. Review
  5. Article
  6. Treatment Approaches to Lacunar Stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2019
    Review
  7. Article
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

3 authors at 1 institution in 1 country.

Shadi YaghiFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., M.S.V.E.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York; and Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY.
Hooman KamelFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., M.S.V.E.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York; and Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY.
Mitchell S V ElkindFrom the Department of Neurology, College of Physicians and Surgeons (S.Y., M.S.V.E.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York; and Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY. mse13@columbia.edu.
Cornell University · US

Funding

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 NS082367
6 · The paper itself

Abstract

backgroundNon-vitamin K antagonist oral anticoagulant (NOAC) drugs are at least equivalent to warfarin for ischemic stroke prevention in patients with atrial fibrillation and have a lower risk of intracranial hemorrhage. The role of these agents in the prevention and treatment of other types of cerebrovascular disease remains unclear.

methodsWe reviewed the literature (randomized trials, exploratory comparative studies, and case series) on the use of NOACs in patients with atrial fibrillation, venous thromboembolism, and cerebrovascular disease independent of atrial fibrillation.

resultsThe literature on the use of NOACs for treatment and prevention of cerebrovascular disease in patients without atrial fibrillation is sparse. The potential benefit of vitamin K antagonists over antiplatelet agents for primary and secondary prevention in certain subsets of patients with cerebrovascular disease is offset by the increased risk of major and intracranial hemorrhage. Given that NOACs are equivalent to vitamin K antagonists in preventing ischemic stroke and systemic embolism in patients with atrial fibrillation with less bleeding risk, clinical trials are needed to investigate the short- and long-term use of NOACs in populations of patients with other forms of cerebrovascular disease, including those with cryptogenic stroke with or without evidence of patent foramen ovale and low ejection fraction, cervical artery dissection, large artery atherosclerosis, venous thrombosis, and stuttering lacunar stroke.

conclusionThere may be a role for NOACs in stroke prevention and treatment beyond atrial fibrillation. Randomized controlled trials are needed to compare NOACs to current stroke prevention and treatment strategies in certain subgroups of patients with cerebrovascular disease.

Indexed as

Vitamin KAdministration, OralAnticoagulantsHumansRandomized Controlled Trials as TopicStrokeTreatment OutcomeAnticoagulantsVitamin K

Identifiers

PMID26187229
PMCPMC4603598
OpenAlexW2163866356

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.