Evidence map›Paper›PMID 32093987›Full record

Observational studyJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2020

Prevalence of a Multiple Territory Stroke Pattern After Intravenous Thrombolysis.

Muhammad Umer Azeem, Muhammad Nagy, Malgorzata M Miller, Mehdi Ghasemi, Abdul Mikati, Brian Silver, Majaz Moonis, Nils Henninger

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2020. 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
0.3field-weighted citation impact, top 42% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  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

8 authors at 1 institution in 1 country.

Muhammad Umer AzeemDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Muhammad NagyDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Malgorzata M MillerDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Mehdi GhasemiDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Abdul MikatiDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Brian SilverDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Majaz MoonisDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Nils HenningerDepartment of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: nils.henninger@umassmed.edu.
University of Massachusetts Chan Medical School · US

Funding

Reducing Brain Injury After Focal Ischemia Using a Nitric Oxide-Neutral Oxygen CarrierR44NS076272 · NINDS · OMNIOX, INC. · PI KRTOLICA, ANA, WINGER, JONATHAN A · 2016 to 2017
$2.3M
Inhibiting axon degeneration in a mouse model of acute brain injury through deletion of Sarm1K08NS091499 · NINDS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI HENNINGER, NILS · 2016 to 2020
$919k
NINDS NIH HHS K08 NS091499NINDS NIH HHS R44 NS076272
6 · The paper itself

Abstract

backgroundIt has been proposed that the presence of a multiple territory stroke pattern (MTSP) on brain imaging may aid identification of patients with covert atrial fibrillation (AF). However, it is uncertain whether this association holds true among patients treated with intravenous recombinant tissue plasminogen activator (rtPA) because clot fragmentation may affect MTSP prevalence. METHODS/

designRetrospective analysis of 149 acute ischemic stroke patients treated with intravenous rtPA who underwent brain MRI. Presence of multiple acute infarctions on brain MRI that involved more than one vascular territory was considered to denote MTSP. Stroke etiology was categorized as nonembolic, cardioembolic (CES), and embolic stroke of undetermined source (ESUS).

resultsIn the entire cohort, subjects with CES and ESUS had significantly more often an MTSP than subjects with other determined stroke mechanism (P= .007). Although numerically relatively more patients had an MTSP as compared to a non-MTSP among subjects with CES (52% versus 33.9%) and ESUS (44% versus 34.7%), this difference did not reach significance after Bonferroni-adjustment for multiple comparisons (P> .05, each). There was no difference in the prevalence of an MTSP among subjects with known (n = 11/51; 21.6%) versus subsequently diagnosed (n = 1/3; 33.3%) AF (P= .54).

conclusionsOur findings indicate that the known association of multiterritory infarct with AF and ESUS is maintained after thrombolysis. In light of its high specificity, MTSP represents a good marker for AF-related stroke etiology; nevertheless, overall sensitivity for AF was low highlighting that an absent MTSP does not rule out AF.

Indexed as

Thrombolytic TherapyAgedAged, 80 and overAtrial FibrillationBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleFibrinolytic AgentsHumansInfusions, IntravenousMaleMassachusettsMiddle AgedPredictive Value of TestsPrevalenceRecombinant ProteinsFibrinolytic AgentsPLAT protein, humanRecombinant ProteinsTissue Plasminogen Activatoracute strokeAtrial fibrillationMRIrecombinant tissue-type plasminogen activatorthrombolysis

Identifiers

PMID32093987
PMCPMC7170755
OpenAlexW3008566868

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.