Evidence map›Paper›PMID 31165095›Full record

ArticleEuropean stroke journal2019

Early recurrence in paroxysmal versus sustained atrial fibrillation in patients with acute ischaemic stroke.

Maurizio Paciaroni, Filippo Angelini, Giancarlo Agnelli, Georgios Tsivgoulis, Karen L Furie, Prasanna Tadi, Cecilia Becattini, Nicola Falocci, Marialuisa Zedde, Azmil H Abdul-Rahim and 89 more

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Article in European stroke journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 27% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
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4 · The record

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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

99 authors at 20 institutions in 13 countries.

Maurizio PaciaroniStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Filippo AngeliniStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Giancarlo AgnelliStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Georgios TsivgoulisSecond Department of Neurology, "Attikon" University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece.
Karen L FurieDivision of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Prasanna TadiDivision of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Cecilia BecattiniStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Nicola FalocciStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Marialuisa ZeddeNeurology Unit, Stroke Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
Azmil H Abdul-RahimMedical School and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Kennedy R LeesMedical School and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Andrea AlbertiStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Michele VentiStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Monica AcciarresiStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Riccardo AltavillaStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Cataldo D'AmoreStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Maria G MosconiStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Ludovica A CiminiStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Paolo BoviSSO Stroke Unit, UO Neurologia, DAI di Neuroscienze, AOUI, Verona, Italy.
Monica CarlettiSSO Stroke Unit, UO Neurologia, DAI di Neuroscienze, AOUI, Verona, Italy.
Alberto RigatelliSSO Stroke Unit, UO Neurologia, DAI di Neuroscienze, AOUI, Verona, Italy.
Manuel CappellariSSO Stroke Unit, UO Neurologia, DAI di Neuroscienze, AOUI, Verona, Italy.
Jukka PutaalaDepartment of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
Liisa TomppoDepartment of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
Turgut TatlisumakDepartment of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
Fabio BandiniDepartment of Neurology, Ospedale San Paolo, Savona, Italy.
Simona MarcheselliNeurologia d'urgenza e Stroke Unit, Istituto Clinico Humanitas, Rozzano, Milano, Italy.
Alessandro PezziniDepartment of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy.
Loris PoliDepartment of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy.
Alessandro PadovaniDepartment of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy.
Luca MasottiInternal Medicine, Santa Maria Nuova Hospital, Firenze, Italy.
Vieri VannucchiInternal Medicine, Santa Maria Nuova Hospital, Firenze, Italy.
Sung-Il SohnDepartment of Neurology, Keimyung University School of Medicine, Daegu, South Korea.
Gianni LorenziniSC di Medicina e Chirurgia d'Accettazione e d'Urgenza degli ospedali di Pontedera e Volterra, Pontedera e Volterra, Italy.
Rossana TassiStroke Unit, AOU Senese, Siena, Italy.
Francesca GuideriStroke Unit, AOU Senese, Siena, Italy.
Maurizio AcampaStroke Unit, AOU Senese, Siena, Italy.ORCID https://orcid.org/0000-0003-4149-1785
Giuseppe MartiniStroke Unit, AOU Senese, Siena, Italy.
George NtaiosDepartment of Medicine, University of Thessaly, Larissa, Greece.
Efstathia KaragkioziDepartment of Medicine, University of Thessaly, Larissa, Greece.
George AthanasakisDepartment of Medicine, University of Thessaly, Larissa, Greece.
Kostantinos MakaritsisDepartment of Medicine, University of Thessaly, Larissa, Greece.
Kostantinos VadikoliasDepartment of Neurology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Chrysoula LiantiniotiSecond Department of Neurology, "Attikon" University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece.
Maria ChondrogianniSecond Department of Neurology, "Attikon" University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece.
Nicola MumoliDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy.
Domenico ConsoliStroke Unit, Jazzolino Hospital, Vibo Valentia, Italy.
Franco GalatiStroke Unit, Jazzolino Hospital, Vibo Valentia, Italy.
Simona SaccoDepartment of Neurology, University of L'Aquila, Avezzano Hospital, Avezzano, Italy.
Antonio CaroleiDepartment of Neurology, University of L'Aquila, Avezzano Hospital, Avezzano, Italy.
Cindy TiseoDepartment of Neurology, University of L'Aquila, Avezzano Hospital, Avezzano, Italy.
Francesco CoreaUO Gravi Cerebrolesioni, San Giovanni Battista Hospital, Foligno, Italy.
Walter AgenoDepartment of Internal Medicine, Insubria University, Varese, Italy.
Marta BellesiniDepartment of Internal Medicine, Insubria University, Varese, Italy.
Giorgio SilvestrelliSC di Neurologia e S.S. di Stroke Unit, ASST di Mantova, Mantova, Italy.
Alfonso CicconeSC di Neurologia e S.S. di Stroke Unit, ASST di Mantova, Mantova, Italy.
Umberto ScodittiStroke Unit, Neuroscience Department, University of Parma, Parma, Italy.
Licia DentiStroke Unit, Dipartimento Geriatrico Riabilitativo, University of Parma, Parma, Italy.
Michelangelo MancusoClinica Neurologica, Azienda Ospedaliero-Universitaria, Pisa, Italy.
Miriam MaccarroneClinica Neurologica, Azienda Ospedaliero-Universitaria, Pisa, Italy.
Giovanni OrlandiClinica Neurologica, Azienda Ospedaliero-Universitaria, Pisa, Italy.
Nicola GianniniClinica Neurologica, Azienda Ospedaliero-Universitaria, Pisa, Italy.
Gino GialdiniClinica Neurologica, Azienda Ospedaliero-Universitaria, Pisa, Italy.
Tiziana TassinariStroke Unit, Department of Neurology, Santa Corona Hospital, Pietra Ligure, Savona, Italy.
Maria Luisa De LodoviciStroke Unit, Neurology, Insubria University, Varese, Italy.
Giorgio BonoStroke Unit, Neurology, Insubria University, Varese, Italy.
Christina RueckertAbteilung für Neurologie, Oberschwabenklinik gGmbH, Ravensburg, Germany.
Antonio BaldiStroke Unit, Ospedale di Portogruaro, Portogruaro, Venice, Italy.
Danilo ToniDepartment of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
Federica LetteriDepartment of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
Martina GiuntiniNeurologia, Ospedale Apuano, Massa Carrara, Italy.
Enrico M LottiUO Neurologia Presidio Ospedaliero di Ravenna Azienda USL della Romagna, Ravenna, Italy.
Yuriy FlominStroke and Neurorehabilitation Unit MC 'Universal Clinic 'Oberig', Kyiv, Ukraine.
Alessio PieroniDepartment of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
Odysseas KargiotisStroke Unit, Metropolitan Hospital, Piraeus, Greece.
Theodore Karapanayiotides2nd Department of Neurology, AHEPA University Hospital, Thessaloniki, Greece.
Serena MonacoStroke Unit, Ospedale Civico, Palermo, Italy.
Mario M BaronelloStroke Unit, Ospedale Civico, Palermo, Italy.
Laszló CsibaStroke Unit, University of Debrecen, Debrecen, Hungary.
Lilla SzabóStroke Unit, University of Debrecen, Debrecen, Hungary.
Alberto ChitiStroke Unit, Department of Neurology, Sant'Andrea Hospital, La Spezia, Italy.
Elisa GiorliStroke Unit, Department of Neurology, Sant'Andrea Hospital, La Spezia, Italy.
Massimo Del SetteStroke Unit, Department of Neurology, Sant'Andrea Hospital, La Spezia, Italy.
Davide ImbertiDepartment of Internal Medicine, Ospedale Civile di Piacenza, Italy.
Dorjan ZabzuniDepartment of Internal Medicine, Ospedale Civile di Piacenza, Italy.
Boris DoroninMunicipal Budgetary Healthcare Institution of Novosibirsk, City Clinical Hospital n° 1, Novosibirsk State Medical University, Novosibirsk, Russia.
Vera VolodinaMunicipal Budgetary Healthcare Institution of Novosibirsk, City Clinical Hospital n° 1, Novosibirsk State Medical University, Novosibirsk, Russia.
Patrik Michel Pd-MerCentre Cérébrovasculaire, Service de Neurologie, Département des Neurosciences Cliniques Centre Hopitalier Universitaire Vaudois, Lausanne, Switzerland.
Peter VanackerDepartment of Neurology, Born Bunge Institute, Antwerp University Hospital, Antwerp, Belgium.
Kristian BarlinnDepartment of Neurology, Dresden University Stroke Center, Dresden, Germany.
Lars P PallesenDepartment of Neurology, Dresden University Stroke Center, Dresden, Germany.
Jessica KepplingerDepartment of Neurology, Dresden University Stroke Center, Dresden, Germany.
Dirk DeleuNeurology, Hamad Medical Corporation, Doha, Qatar.
Gayane MelikyanNeurology, Hamad Medical Corporation, Doha, Qatar.
Faisal IbrahimNeurology, Hamad Medical Corporation, Doha, Qatar.
Naveed AkhtarNeurology, Hamad Medical Corporation, Doha, Qatar.
Vanessa GourbaliDepartment of Neurology, Evangelismos Hospital, Athens, Greece.
Shadi YaghiDivision of Stroke and Cerebrovascular Diseases, Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Valeria CasoStroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
University of Perugia · ITAzienda Ospedaliera Universitaria Pisana · ITAzienda Ospedaliera Universitaria Senese · ITHamad Medical Corporation · QAUniversity of Insubria · ITUniversity of Thessaly · GRUniversity of Verona · ITBrown University · USHelsinki University Hospital · FIHochschule für Technik und Wirtschaft Dresden – University of Applied Sciences · DESapienza University of Rome · ITUniversity of Brescia · ITUniversity of L'Aquila · ITAccademia di Belle Arti di Carrara · ITAzienda di Rilievo Nazionale ed Alta Specializzazione · ITCTO Andrea Alesini · ITJazz Pharmaceuticals (Italy) · ITMusic Conservatory of Mantova · ITNational and Kapodistrian University of Athens · GRNovosibirsk State Medical University · RU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe relationship between different patterns of atrial fibrillation and early recurrence after an acute ischaemic stroke is unclear. PURPOSE: In a prospective cohort study, we evaluated the rates of early ischaemic recurrence after an acute ischaemic stroke in patients with paroxysmal atrial fibrillation or sustained atrial fibrillation which included persistent and permanent atrial fibrillation.

methodsIn patients with acute ischaemic stroke, atrial fibrillation was categorised as paroxysmal atrial fibrillation or sustained atrial fibrillation. Ischaemic recurrences were the composite of ischaemic stroke, transient ischaemic attack and symptomatic systemic embolism occurring within 90 days from acute index stroke.

resultsA total of 2150 patients (1155 females, 53.7%) were enrolled: 930 (43.3%) had paroxysmal atrial fibrillation and 1220 (56.7%) sustained atrial fibrillation. During the 90-day follow-up, 111 ischaemic recurrences were observed in 107 patients: 31 in patients with paroxysmal atrial fibrillation (3.3%) and 76 with sustained atrial fibrillation (6.2%) (hazard ratio (HR) 1.86 (95% CI 1.24-2.81)). Patients with sustained atrial fibrillation were on average older, more likely to have diabetes mellitus, hypertension, history of stroke/ transient ischaemic attack, congestive heart failure, atrial enlargement, high baseline NIHSS-score and implanted pacemaker. After adjustment by Cox proportional hazard model, sustained atrial fibrillation was not associated with early ischaemic recurrences (adjusted HR 1.23 (95% CI 0.74-2.04)).

conclusionsAfter acute ischaemic stroke, patients with sustained atrial fibrillation had a higher rate of early ischaemic recurrence than patients with paroxysmal atrial fibrillation. After adjustment for relevant risk factors, sustained atrial fibrillation was not associated with a significantly higher risk of recurrence, thus suggesting that the risk profile associated with atrial fibrillation, rather than its pattern, is determinant for recurrence.

Indexed as

anticoagulationatrial fibrillationparoxysmal atrial fibrillationStrokestroke recurrencesustained atrial fibrillation

Identifiers

PMID31165095
PMCPMC6533867
OpenAlexW2884120333

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