Evidence map›Paper›PMID 26585394›Full record

Observational studyStroke2016

Reperfusion Beyond 6 Hours Reduces Infarct Probability in Moderately Ischemic Brain Tissue.

Hongyu An, Andria L Ford, Cihat Eldeniz, Yasheng Chen, Katie D Vo, Hongtu Zhu, William J Powers, Weili Lin, Jin-Moo Lee

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
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

9 authors.

Hongyu AnFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
Andria L FordFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
Cihat EldenizFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
Yasheng ChenFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
Katie D VoFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
Hongtu ZhuFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
William J PowersFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
Weili LinFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
Jin-Moo LeeFrom the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill. leejm@neuro.wustl.edu weili_lin@med.unc.edu.

Funding

Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
Washington University SPOTRIAS Center - Stroke Trials Registry / Web InterfaceP50NS055977 · NINDS · WASHINGTON UNIVERSITY · PI NASSIEF, ADBULLAH M. · 2008 to 2012
$10.1M
Rapid, robust and non-invasive cerebral oxygenation measurements using MRIR01NS082561 · NINDS · WASHINGTON UNIVERSITY · PI AN, HONGYU · 2014 to 2018
$2.8M
DEFINING THE ISCHEMIC PENUMBRA WITH MAGNETIC RESONANCE OXYGEN METABOLISMK23NS069807 · NINDS · WASHINGTON UNIVERSITY · PI FORD, ANDRIA LEE · 2011 to 2015
$872k
NCATS NIH HHS UL1 TR000448NINDS NIH HHS 1R01 NS082561NINDS NIH HHS 5P50NS055977NINDS NIH HHS K23 NS069807NINDS NIH HHS P50 NS055977NINDS NIH HHS R01 NS082561
6 · The paper itself

Abstract

background and purposeWe aimed to examine perfusion changes between 3 and 6 and 6 and 24 hours after stroke onset and their impact on tissue outcome.

methodsAcute ischemic stroke patients underwent perfusion magnetic resonance imaging at 3, 6, and 24 hours after stroke onset and follow-up fluid-attenuated inversion recovery at 1 month to assess tissue fate. Mean transit time prolongation maps (MTTp=MTT-[median MTT of contralateral hemisphere]) were obtained at 3 (MTTp3 h), 6 (MTTp6 h), and 24 hours (MTTp24 h). Perfusion changes between 3 and 6 hours (ΔMTTp3_6) and 6 and 24 hours (ΔMTTp6_24) were calculated. A 2-step analysis was performed to evaluate the impact of ΔMTTp3_6 and ΔMTTp6_24 on tissue fate. First, a voxel-based multivariable logistic regression was performed for each individual patient with MTTp3 h, ΔMTTp3_6, and ΔMTT6_24 as independent variables and tissue fate as outcome. Second, Wilcoxon signed-rank tests on logistic regression coefficients were performed across patients to evaluate whether ΔMTTp3_6 and ΔMTT6_24 had significant impact on tissue fate for varying severities of baseline perfusion.

resultsPerfusion change was common during both time periods: 85% and 81% of patients had perfusion improvement during 3- to 6- and 6- and 24-hour time intervals, respectively. ΔMTT3_6 significantly influenced 1-month infarct probability across a wide range of baseline perfusion (MTTp 0-15 s). ΔMTT6_24 also impacted 1-month infarct probability, but its influence was restricted to tissue with milder baseline ischemia (MTTp 0-10 s).

conclusionsBrain tissue with mild to moderate ischemia can be salvaged by reperfusion even after 6 hours. Such tissue could be targeted for intervention beyond current treatment windows.

Indexed as

AgedBrain IschemiaCerebral InfarctionHumansMagnetic Resonance AngiographyMiddle AgedProspective StudiesReperfusionStrokeTime FactorsbrainischemiaMR perfusion imagingreperfusionstroketissue outcome

Identifiers

PMID26585394
PMCPMC4696879

What OpenQuestion holds

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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.