Evidence map›Paper›PMID 34021676›Full record

ArticlePharmacoepidemiology and drug safety2021

Oral anticoagulant therapy and outcome in patients with stroke. A retrospective nation-wide cohort study in Austria 2012-2017.

Jasmina Preinreich, Safoura Sheikh Rezaei, Martina Mittlböck, Stefan Greisenegger, Berthold Reichardt, Michael Wolzt

Open access · hybridAbstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 30% 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. 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

6 authors at 2 institutions in 1 country.

Jasmina PreinreichDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Safoura Sheikh RezaeiDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Martina MittlböckCenter for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Stefan GreiseneggerDepartment of Neurology, Medical University of Vienna, Vienna, Austria.
Berthold ReichardtAustrian Health Insurance Fund, Burgenland, Eisenstadt, Burgenland, Austria.
Michael WolztDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Medical University of Vienna · ATUniversity of Applied Sciences Burgenland · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients with stroke are at high risk of recurrence of vascular events. Non-vitamin K oral anticoagulant (NOAC) and vitamin K antagonists (VKA) are used as secondary prophylaxis. The aim of this study was to evaluate the utilization of NOAC and VKA, and their impact on re-stroke or death in Austria.

methodsWe analyzed retrospective data between 2012 and 2017 from medical services covered by the health insurance funds, which provides health care for all residents in Austria. Patients without anticoagulant medication 3 months preceding the index event were eligible.

results76 354 patients were discharged with a hospital diagnosis of stroke. From these, 16 436 patients with a median age of 78 years received VKA or NOAC. After adjustment, the recurrence of stroke was less frequent in patients with NOAC compared to those with VKA (HR 0.87; 95%CI 0.77-0.97). However, there was no difference in mortality rate after adjustment for age, sex, and co-morbidities for patients with NOAC (HR 1.0; 95%CI 0.92-1.08). Diabetes (HR 1.25, 95%CI 1.08-1.45; HR 1.25, 95% CI 1.13-1.38) and cardiovascular disease (HR 1.43, 95%CI 1.24-1.65; HR 1.27, 95%CI 1.16-1.39) were significantly associated with re-stroke or death. Younger age (p = 0.0028; HR 0.99, 95%CI 0.99-0.99) was significantly associated with re-stroke, and advanced age (p < 0.0001; HR 1.09, 95%CI 1.08-1.09) with death.

conclusionNOAC prescription is related with a reduced risk of re-stroke but increased mortality compared to patients with VKA. The event risk is associated with diabetes, cardiovascular disease and age.

Indexed as

AnticoagulantsStrokeAgedAustriaCohort StudiesHumansRetrospective StudiesAnticoagulantsdrug utilizationNOACpharmacoepidemiologystrokeVKA

Identifiers

PMID34021676
PMCPMC8453954
OpenAlexW3161317611

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Registered trials

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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.