Evidence map›Paper›PMID 29251360›Full record

Trial reportClinical cardiology2017

Laboratory characteristics of ischemic stroke patients with atrial fibrillation on or off therapeutic warfarin.

Raghav V Aachi, Lee A Birnbaum, Christopher H Topel, Ali Seifi, Shaheryar Hafeez, Réza Behrouz

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Clinical cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Trial
  2. 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

6 authors.

Raghav V AachiDepartment of Neurology, University of Texas Lozano Long School of Medicine, San Antonio.
Lee A BirnbaumDepartment of Neurology, University of Texas Lozano Long School of Medicine, San Antonio.
Christopher H TopelDepartment of Neurology, University of Texas Lozano Long School of Medicine, San Antonio.
Ali SeifiDepartment of Neurological Surgery, University of Texas Lozano Long School of Medicine, San Antonio.
Shaheryar HafeezDepartment of Neurological Surgery, University of Texas Lozano Long School of Medicine, San Antonio.
Réza BehrouzDepartment of Neurology, University of Texas Lozano Long School of Medicine, San Antonio.ORCID http://orcid.org/0000-0002-3684-434X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with atrial fibrillation (AF), despite adequate anticoagulation, ischemic stroke (IS) is an uncommon yet concerning occurrence. HYPOTHESIS: Specific laboratory parameters may affect the efficacy of warfarin despite therapeutic international normalized ratio (INR) in patient with AF who present with IS.

methodsWe used the database from a multicenter clinical trial to identify AF patients who presented with IS. We trichotomized the cohort into patients with therapeutic INR on warfarin, subtherapeutic INR on warfarin, and on no anticoagulants. We then compared baseline laboratory characteristics and other baseline features among the groups.

resultsPatients with therapeutic INR presented with higher serum creatinine (P = 0.01) and blood urea nitrogen (P = 0.02) and lower glomerular filtration rates (P = 0.001) compared with other groups. Other laboratory parameters were not different among the 3 groups. Patients with therapeutic INR also presented with milder stroke symptoms (P = 0.01). Medical history of the 3 groups was not different, except for history of valvular heart disease, which was more prevalent in patients with therapeutic INR (P = 0.004). In-hospital mortality rates and 90-day disability were not different among the 3 groups.

conclusionsAF patients who presented with IS on therapeutic warfarin had higher average serum creatinine and blood urea nitrogen, and lower glomerular filtration rates, compared with others. Impaired renal function may be a factor contributing to occurrence of IS in AF patients despite adequate anticoagulation. Larger, targeted studies are needed to confirm these findings.

Indexed as

Administration, OralAgedAnticoagulantsAtrial FibrillationBlood CoagulationBrain IschemiaDose-Response Relationship, DrugDouble-Blind MethodFemaleFollow-Up StudiesHospital MortalityHumansMalePrevalenceSurvival RateTreatment OutcomeAnticoagulantsWarfarinAcute StrokeAnticoagulationAtrial FibrillationInternational Normalized RatioWarfarin

Identifiers

PMID29251360
PMCPMC6490348

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Registered trials

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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.