Evidence map›Paper›PMID 29185557›Full record

ArticleNeurology. Clinical practice2017

Frequency, determinants, and effects of early seizures after thrombolysis for acute ischemic stroke: The ENCHANTED trial.

Ying Xu, Maree L Hackett, John Chalmers, Richard I Lindley, Xia Wang, Qiang Li, Thompson Robinson, Hisatomi Arima, Pablo M Lavados, Craig S Anderson and 1 more

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

Article in Neurology. Clinical practice, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01422616 (An International Randomised Controlled Trial to Establish the Effects of Low-dose rtPA and the Effects of Early Intensive Blood Pressure Lowering in Patients With Acute Ischaemic Stroke), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.4field-weighted citation impact, top 18% 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.

NCT01422616 phase3completednot on this map

An International Randomised Controlled Trial to Establish the Effects of Low-dose rtPA and the Effects of Early Intensive Blood Pressure Lowering in Patients With Acute Ischaemic Stroke

TypeinterventionalSponsorThe George InstituteRan2012 to 2018Enrolled4,587ConditionsIschemic Stroke, High Blood PressureArmsLow-dose rtPA, Standard-dose rtPA, Intensive blood pressure (BP) lowering, BP management policies
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 20 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Observational
  5. Observational
  6. Article
  7. Article
  8. 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

11 authors at 2 institutions in 5 countries.

Ying XuThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Maree L HackettThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
John ChalmersThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Richard I LindleyThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Xia WangThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Qiang LiThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Thompson RobinsonThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Hisatomi ArimaThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Pablo M LavadosThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
Craig S AndersonThe George Institute for Global Health (YX, MLH, JC, RIL, XW, QL, HA, CSA), University of New South Wales; Sydney Medical School (YX, MLH, JC, RIL, CSA), the University of Sydney, Australia; Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases (TR), University of Leicester, UK; Department of Preventive Medicine and Public Health (HA), Faculty of Medicine, Fukuoka University, Japan; Clinica Alemana de Santiago, Facultad de Medicina (PML), Clinica Alemana Universidad del Desarrollo; Departamento de Ciencias Neurológicas (PML), Facultad de Medicina, Universidad de Chile, Santiago; Neurology Department (CSA), Royal Prince Alfred Hospital, Sydney, Australia; and The George Institute China at Peking University Health Science Center (CSA), Beijing PR China.
ENCHANTED Study Group
The University of Sydney · AUThe George Institute for Global Health · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeizures after ischemic stroke have not been well-studied. We aim to determine the frequency, determinants, and significance of early seizures after thrombolysis for acute ischemic stroke.

methodsData are from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED), an international, multicenter, randomized controlled trial where patients with acute ischemic stroke were randomized to low-dose (0.6 mg/kg) or standard-dose (0.9 mg/kg) IV alteplase. The protocol prespecified prospective data collection on in-hospital seizures over 7 days postrandomization. Logistic regression models were used to determine variables associated with seizures and their significance on poor outcomes of death or disability (modified Rankin scale scores 3-6), symptomatic intracerebral hemorrhage (sICH), and European Quality of Life 5-Dimensions questionnaire [EQ-5D] over 90 days.

resultsData were available for 3,139 acute ischemic stroke participants, of whom 42 (1.3%) had seizures at a median 22.7 hours after the onset of symptoms. Baseline variables associated with seizures were male sex (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.07-4.50), severe neurologic impairment (NIH Stroke Scale score ≥10; OR 2.16, 95% CI 1.06-4.40), and fever (OR 4.55, 95% CI 2.37-8.71). Seizures independently predicted poor recovery: death or major disability (OR 2.88, 95% CI 1.28-6.47), unfavorable ordinal shift of mRS scores (OR 1.94, 95% CI 1.10-3.39), and lower than median EQ-5D health utility index score (OR 3.50, 95% CI 1.37-8.91). There was no association of seizures with sICH in adjusted analysis.

conclusionsIn thrombolysis-treated patients with acute ischemic stroke, seizures are uncommon, occur early, and predict poor recovery. CLINICALTRIALSGOV IDENTIFIER: NCT01422616.

Identifiers

PMID29185557
PMCPMC5648202
OpenAlexW2738774636

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.