Evidence map›Paper›PMID 31949087›Full record

ReviewNeurology2020

Risk of hemorrhagic and ischemic stroke in patients with Alzheimer disease: A synthesis of the literature.

Reem Waziry, Lori B Chibnik, Daniel Bos, M Kamran Ikram, Albert Hofman

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 2 pooled it
–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

34 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Review
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. 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

5 authors.

Reem WaziryFrom the Department of Epidemiology (R.W., L.B.C., D.B., A.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology (R.W., D.B., M.K.I., A.H.), Department of Radiology and Nuclear Medicine (D.B.), and Department of Neurology (M.K.I.), Erasmus Medical Center, Rotterdam, The Netherlands. waziry@hsph.harvard.edu.
Lori B ChibnikFrom the Department of Epidemiology (R.W., L.B.C., D.B., A.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology (R.W., D.B., M.K.I., A.H.), Department of Radiology and Nuclear Medicine (D.B.), and Department of Neurology (M.K.I.), Erasmus Medical Center, Rotterdam, The Netherlands.
Daniel BosFrom the Department of Epidemiology (R.W., L.B.C., D.B., A.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology (R.W., D.B., M.K.I., A.H.), Department of Radiology and Nuclear Medicine (D.B.), and Department of Neurology (M.K.I.), Erasmus Medical Center, Rotterdam, The Netherlands.
M Kamran IkramFrom the Department of Epidemiology (R.W., L.B.C., D.B., A.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology (R.W., D.B., M.K.I., A.H.), Department of Radiology and Nuclear Medicine (D.B.), and Department of Neurology (M.K.I.), Erasmus Medical Center, Rotterdam, The Netherlands.
Albert HofmanFrom the Department of Epidemiology (R.W., L.B.C., D.B., A.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology (R.W., D.B., M.K.I., A.H.), Department of Radiology and Nuclear Medicine (D.B.), and Department of Neurology (M.K.I.), Erasmus Medical Center, Rotterdam, The Netherlands.

Funding

Research Education ComponentP30AG062421 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI STEVEN E ARNOLD · 2019 to 2026
$36.5M
NIA NIH HHS P30 AG062421
6 · The paper itself

Abstract

objectiveTo assess the risk of hemorrhagic and ischemic stroke in patients with Alzheimer disease (AD) compared with non-AD controls with similar risk profiles.

methodsA search was conducted on EMBASE and MEDLINE for reports published up to September 26, 2018. Studies were included if they (1) assessed the incidence of stroke in patients diagnosed with AD; (2) included patients with no history of stroke; and (3) reported outcomes by stroke subtype. The main outcome was relative risk of ischemic or hemorrhagic stroke. Furthermore, the rate of stroke occurrence per 1,000 person-years was assessed. A random-effects meta-analysis was undertaken. The risk of bias in included studies was assessed in terms of selection, comparability, and outcome.

resultsA total of 3,605 studies were screened in the title and abstract phase after removing duplicates, and 88 eligible studies were screened for full text. Eight studies met the inclusion criteria representing 121,719 individuals (AD = 73,044; non-AD = 48,675). Five studies were included in the relative risk analysis, among which 4 studies applied formal matching criteria of 44,544 AD and 44,660 non-AD controls. The included studies were based on nationwide registries from Finland, Sweden, Taiwan (2), United Kingdom (2), 1 clinic-based study from the Netherlands, and 1 US population-based cohort. Among patients with AD, the incidence rate of hemorrhagic stroke was 3.41/1000 person-years (95% CI 2.70-4.32) and 2.23 (95% CI 1.72-2.88) among AD cases and non-AD controls, respectively. This is in contrast to 13.98 (95% CI 9.86-19.81) and 12.12 (95% CI 7.55-19.46) for ischemic stroke among AD cases and non-AD controls, respectively. Compared with non-AD controls with similar risk profiles, patients with AD had a relative risk of 1.42 (95% CI 1.23-1.64) for hemorrhagic stroke and 1.15 (95% CI 0.89-1.48) for ischemic stroke.

conclusionCompared with non-AD controls with similar risk profiles, patients with AD are likely at a higher risk of hemorrhagic but not ischemic stroke.

Indexed as

Alzheimer DiseaseBrain IschemiaCase-Control StudiesHumansIncidenceIntracranial HemorrhagesRiskStroke

Identifiers

PMID31949087
PMCPMC7136067

What OpenQuestion holds

Textmetadata
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.