Evidence map›Paper›PMID 28419982›Full record

Trial reportCerebrovascular diseases (Basel, Switzerland)2017

Resting Heart Rate and Ischemic Stroke in Patients with Heart Failure.

Koki Nakanishi, Marco R Di Tullio, Min Qian, John L P Thompson, Arthur J Labovitz, Douglas L Mann, Ralph L Sacco, Patrick M Pullicino, Ronald S Freudenberger, John R Teerlink and 11 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cerebrovascular diseases (Basel, Switzerland), 2017. 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, top 94% 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

6 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Observational
  3. Review
  4. Article
  5. Left atrial 4D flow cardiovascular magnetic resonance: a reproducibility study in sinus rhythm and atrial fibrillation.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021
    Article
  6. 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

21 authors at 11 institutions in 4 countries.

Koki NakanishiDepartment of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY, USA.
Marco R Di Tullio
Min Qian
John L P Thompson
Arthur J Labovitz
Douglas L Mann
Ralph L Sacco
Patrick M Pullicino
Ronald S Freudenberger
John R Teerlink
Susan Graham
Gregory Y H Lip
Bruce Levin
Jay P Mohr
Richard Buchsbaum
Conrado J Estol
Dirk J Lok
Piotr Ponikowski
Stefan D Anker
Shunichi Homma
WARCEF Investigators
Columbia University Irving Medical Center · USDeventer Ziekenhuis · NLInstituto de Neurología Cognitiva · ARLehigh Valley Hospital-Pocono · USSan Francisco VA Medical Center · USSUNY Upstate Medical University · USUniversity of Birmingham · GBUniversity of Kent · GBUniversity of Miami · USUniversity of South Florida · USWashington University in St. Louis · US

Funding

Warfarin vs. Aspirin in Reduced Ejection Fraction (WARCEF)U01NS043975 · NINDS · UNIV OF MED/DENT OF NJ-NJ MEDICAL SCHOOL · PI HOMMA, SHUNICHI · 2001 to 2010
$43.3M
Warfarin vs Aspirin in Reduced Ejection Fraction -STATU01NS039143 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI THOMPSON, JOHN L · 2001 to 2010
$21.3M
NINDS NIH HHS U01 NS039143NINDS NIH HHS U01 NS043975
6 · The paper itself

Abstract

backgroundAlthough high resting heart rate (RHR) is known to be associated with an increased risk of mortality and hospital admission in patients with heart failure, the relationship between RHR and ischemic stroke remains unclear. This study is aimed at investigating the relationship between RHR and ischemic stroke in patients with heart failure in sinus rhythm.

methodsWe examined 2,060 patients with systolic heart failure in sinus rhythm from the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial. RHR was determined from baseline electrocardiogram, and was examined as both a continuous variable and a categorical variable using quartiles. Ischemic strokes were identified during follow-up and adjudicated by physician review.

resultsDuring 3.5 ± 1.8 years of follow-up, 77 patients (5.3% from Kaplan-Meier [KM] curve) experienced an ischemic stroke. The highest incidence of ischemic stroke (21/503 [KM 6.9%]) was observed in the lowest RHR quartile (RHR <64 beats/min) compared to other groups; 22/573 (KM 5.3%) in 64-70 beats/min, 13/465 (KM 3.5%) in 71-79 beats/min, and 21/519 (KM 5.4%) in RHR >79 beats/min (p = 0.693). Multivariable Cox proportional hazards analysis revealed that RHR was significantly associated with ischemic stroke (hazard ratio per unit decrease: 1.07, 95% CI 1.02-1.13, when RHR <64/beats/min; p = 0.038), along with a history of stroke or transient ischemic attack and left ventricular ejection fraction.

conclusionsIn contrast to its beneficial effect on mortality and hospital re-admissions, lower RHR may increase the risk of ischemic stroke in patients with systolic heart failure in sinus rhythm.

Indexed as

Adrenergic beta-AntagonistsAgedAnticoagulantsBrain IschemiaElectrocardiographyFemaleFibrinolytic AgentsHeart FailureHeart RateHumansIncidenceKaplan-Meier EstimateLinear ModelsMaleMiddle AgedMultivariate AnalysisAdrenergic beta-AntagonistsAnticoagulantsFibrinolytic AgentsPlatelet Aggregation InhibitorsBeta-blockerHeart failureIschemic strokeResting heart rateSinus rhythmWarfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial

Identifiers

PMID28419982
PMCPMC5540738
OpenAlexW2605685587

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.