SynthesisBMC neurology2021
Efficacy and safety of thrombolysis for acute ischemic stroke with atrial fibrillation: a meta-analysis.
Synthesis in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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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.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Atrial Fibrillation and Clinical Outcomes of Endovascular Thrombectomy for Acute Ischemic Stroke: A Meta-Analysis of Adjusted Effect Estimates.Journal of the American Heart Association · 2023Pooled it
- Disparities in anticoagulation therapy for older adults with non-valvular atrial fibrillation: a comparative study of urban and suburban communities.BMC geriatrics · 2026Article
- Nomogram for Predicting Hemorrhagic Transformation Risk in Acute Ischemic Stroke Patients With Atrial Fibrillation.CNS neuroscience & therapeutics · 2025Article
- Atrial fibrillation is associated with increased in-hospital mortality and complications after IV t-PA in acute ischemic stroke: evidence from the China Stroke Center Alliance (CSCA).Frontiers in neurology · 2025Article
- Reperfusion therapies in patients with acute ischaemic stroke and atrial fibrillation: data on safety and effectiveness from a multi-centre cohort study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Presence of Residual Cardiac Thrombus Predicts Poor Outcome in Cardioembolic Stroke After Reperfusion Therapy.Journal of the American Heart Association · 2024Article
- Stroke emboli from patients with atrial fibrillation enriched with neutrophil extracellular traps.Research and practice in thrombosis and haemostasis · 2024Article
- Stratifying by Blood Glucose Levels to Predict Hemorrhagic Transformation Risk Post-Rt-PA in Acute Ischemic Stroke.Clinical interventions in aging · 2024Article
- Diagnosis and Management of Atrial Fibrillation in Acute Ischemic Stroke in the Setting of Reperfusion Therapy: Insights and Strategies for Optimized Care.Journal of cardiovascular development and disease · 2023Review
- Atrial Fibrillation and Reperfusion Therapy in Acute Ischaemic Stroke Patients: Prevalence and Outcomes-A Comprehensive Systematic Review and Meta-Analysis.Neurology international · 2023Article
- Reversible and Non-Competitive Inhibition of Cyclooxygenase by Indobufen for Efficient Antiplatelet Action and Relief of Gastrointestinal Irritation.Pharmaceutics · 2023Article
- Predicting Adverse Recanalization Therapy Outcomes in Acute Ischemic Stroke Patients Using Characteristic Gut Microbiota.Microorganisms · 2023Article
- Baseline brain imaging signs in patients with ischaemic stroke by the presence of atrial fibrillation: the ENCHANTED trial.Journal of neurology · 2023Article
- Article
- Correlation of Atherosclerotic Dyslipidemia with Long-Term Stroke Recurrence in Patients Undergoing Intravenous Thrombolysis for Acute Ischemic Stroke.International journal of general medicine · 2023Article
- Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation.Journal of the American Heart Association · 2022Observational
- Comparison of Different Dosages of Alteplase in Atrial Fibrillation-Related Acute Ischemic Stroke After Intravenous Thrombolysis: A Nationwide, Multicenter, Prospective Cohort Study in Taiwan.Journal of the American Heart Association · 2022Article
- Identification of magnetic resonance imaging features for the prediction of unrecognized atrial fibrillation in acute ischemic stroke.Frontiers in neurology · 2022Article
- Factors Associated with Unfavorable Functional Outcomes After Intravenous Thrombolysis in Patients with Acute Ischemic Stroke.International journal of general medicine · 2022Article
- Stroke Aetiology and Collateral Status in Acute Ischemic Stroke Patients Receiving Reperfusion Therapy-A Meta-Analysis.Neurology international · 2021Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundThe efficacy and safety of intravenous thrombolysis (IVT) for acute ischemic stroke with atrial fibrillation (AF) is still controversial.
methodsWe conducted a meta-analysis of all relevant studies, retrieved through systematic search of PubMed, Embase, and Cochrane databases up to December 31, 2019. Modified Rankin Scale (mRS) scores of 0-1 at 90 days, mRS of 0-2 at 90 days, overall mortality, and incidence of symptomatic intracranial hemorrhage (sICH) were collected as outcome measures. Fixed- and random-effects meta-analytical models were applied, and between-study heterogeneity was assessed.
resultsA total of 8509 patients were enrolled in 18 studies. A comparison of IVT treatment in AF versus non-AF patients showed that AF was associated with a significantly lower proportion of patients with mRS of 0-1 (24.1% vs. 34.5%; OR 0.59; 95% CI 0.43-0.81; P < 0.001), mRS of 0-2 (33.6% vs. 47.8%; OR 0.55; 95% CI 0.43-0.70; P < 0.001), as well as significantly higher mortality (19.4% vs. 11.5%; OR 2.05; 95% CI 1.79-2.36; P < 0.001) and higher incidence of sICH (6.4% vs. 4.1%; OR 1.60; 95% CI 1.27-2.01; P < 0.001). A comparison of AF patients who were subjected or not to IVT showed that thrombolysis carried a higher risk of sICH (5.7% vs. 1.6%; OR 3.44; 95% CI 2.04-5.82; P < 0.001) and was not associated with a better prognosis. Subgroup analysis in prospective studies also suggested a poorer functional prognosis and higher mortality in AF patients treated with IVT compared with those who did not receive IVT. Some heterogeneity was present in this meta-analysis.
conclusionsAcute IS patients with AF had worse outcomes than those without AF after thrombolytic therapy, and had a higher incidence of sICH after thrombolysis than those without thrombolysis. Thrombolysis in ischemic stroke patients with AF should be carefully considered based on clinical factors such as NIHSS score, age, and the type of AF.
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