ArticleJournal of neurology, neurosurgery, and psychiatry2021
Ischaemic stroke on anticoagulation therapy and early recurrence in acute cardioembolic stroke: the IAC study.
Article in Journal of neurology, neurosurgery, and psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07171242 (Shanghai Prospective Registry Study of Ischemic Stroke), which is not on this map. Cited by 40 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.
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.
Shanghai Prospective Registry Study of Ischemic Stroke
Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Predictive value of neutrophil to lymphocyte ratio for ischemic stroke in patients with atrial fibrillation: A meta-analysis.Frontiers in neurology · 2022Pooled it
- Catheter Ablation and Oral Anticoagulation for Secondary Stroke Prevention in Atrial Fibrillation: The STABLED Randomized Clinical Trial.JAMA neurology · 2026Trial
- Recurrent Stroke Following Left Atrial Appendage Closure in Patients with Breakthrough Stroke: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Decoding the causes of ischemic stroke despite ongoing oral anticoagulation and their clinical impact: the ASPERA-R study.Journal of neurology · 2026Article
- Integrated bioinformatics and network search identify biomarkers and comorbid mechanisms of atrial fibrillation and ischemic stroke.Medicine · 2026Article
- Collaborative neurocardiology board meetings for decision-making in stroke care: a real-world experience.Neurological research and practice · 2026Article
- Research Advances in Timing of Anticoagulant Therapy Following Cardioembolic Stroke.Clinical Medicine Insights. Cardiology · 2026Review
- Ischemic Stroke in Patients Under Oral Anticoagulation: The Achilles Heel of Atrial Fibrillation Management.Brain sciences · 2025Review
- Ischemic stroke prevention in patients with atrial fibrillation and a recent ischemic stroke, TIA, or intracranial hemorrhage: A World Stroke Organization (WSO) scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025Review
- Left atrial appendage closure in patients with atrial fibrillation and acute ischaemic stroke despite anticoagulation.Stroke and vascular neurology · 2025Article
- Multidisciplinary approach in the management of simultaneous stroke and acute arterial ischemia of the arteries of the upper extremity: A case report.Radiology case reports · 2025Article
- Left atrial appendage occlusion plus oral anticoagulation in stroke patients despite ongoing anticoagulation: rationale and design of the ADD-LAAO clinical trial.REC, interventional cardiology · 2025Article
- Beyond Anticoagulation: Limitations of Oral Anticoagulants in Preventing Stroke Recurrence in Atrial Fibrillation.Journal of clinical medicine · 2024Article
- The Impact of Changing Antithrombotic Management in Patients With Atrial Fibrillation and Ischemic Cerebrovascular Events Despite Anticoagulation.The Neurohospitalist · 2024Article
- Left Atrial Appendage Occlusion vs Standard of Care After Ischemic Stroke Despite Anticoagulation.JAMA neurology · 2024Article
- Efficacy and safety of oral factor Xa inhibitors versus vitamin-K antagonists in the early phase after acute ischemic stroke or TIA in the real-world setting: The PRODAST study.European stroke journal · 2024Observational
- Keeping prior anticoagulation treatment in the acute phase of ischaemic stroke: the REKOALA study.Journal of neurology · 2024Article
- Impact of left ventricular diastolic function and direct oral anticoagulant use for predicting embolic events in patients with heart failure and atrial fibrillation.Journal of arrhythmia · 2024Article
- Changing or Retaining Direct Oral Anticoagulant After Ischemic Stroke Despite Direct Oral Anticoagulant Treatment.Journal of the American Heart Association · 2024Article
- Ischaemic stroke in a patient with non-valvular atrial fibrillation (NVAF) despite non-vitamin K oral anticoagulant (NOAC) therapy.BMJ case reports · 2024Article
Corrections and comments
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Authors and funding
32 authors at 13 institutions in 2 countries.
Funding
Abstract
background and purposeA subset of ischaemic stroke patients with atrial fibrillation (AF) have ischaemic stroke despite anticoagulation. We sought to determine the association between prestroke anticoagulant therapy and recurrent ischaemic events and symptomatic intracranial haemorrhage (sICH).
methodsWe included consecutive patients with acute ischaemic stroke and AF from the Initiation of Anticoagulation after Cardioembolic stroke (IAC) study from eight comprehensive stroke centres in the USA. We compared recurrent ischaemic events and delayed sICH risk using adjusted Cox regression analyses between patients who were prescribed anticoagulation (ACp) versus patients who were naïve to anticoagulation therapy prior to the ischaemic stroke (anticoagulation naïve).
resultsAmong 2084 patients in IAC, 1518 had prior anticoagulation status recorded and were followed for 90 days. In adjusted Cox hazard models, ACp was associated with some evidence of a higher risk higher risk of 90-day recurrent ischaemic events only in the fully adjusted model (adjusted HR 1.50, 95% CI 0.99 to 2.28, p=0.058) but not increased risk of 90-day sICH (adjusted HR 1.08, 95% CI 0.46 to 2.51, p=0.862). In addition, switching anticoagulation class was not associated with reduced risk of recurrent ischaemic events (adjusted HR 0.41, 95% CI 0.12 to 1.33, p=0.136) nor sICH (adjusted HR 1.47, 95% CI 0.29 to 7.50, p=0.641).
conclusionAF patients with ischaemic stroke despite anticoagulation may have higher recurrent ischaemic event risk compared with anticoagulation-naïve patients. This suggests differing underlying pathomechanisms requiring different stroke prevention measures and identifying these mechanisms may improve secondary prevention strategies.
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Registered trials
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.