Evidence map›Paper›PMID 34935409›Full record

Observational studyJournal of the American Heart Association2022

Differences Between Anticoagulated Patients With Ischemic Stroke Versus Intracerebral Hemorrhage.

Fabian Schaub, Alexandros A Polymeris, Sabine Schaedelin, Lisa Hert, Louisa Meya, Sebastian Thilemann, Christopher Traenka, Benjamin Wagner, David Seiffge, Henrik Gensicke and 5 more

Registry-linked trialOpen access · goldAbstract readObservational Study
In one paragraph

Observational study in Journal of the American Heart Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02353585 (A Registry of Novel Oral AntiCoagulants and Vitamin K-antagonists In Stroke Patients - a Multi-center Audit Addressing a) Intracerebral Haemorrhage and b) Acute Ischemic Stroke in Patients Treated With Oral Anticoagulants), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 76% 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.

NCT02353585 completednot on this map

A Registry of Novel Oral AntiCoagulants and Vitamin K-antagonists In Stroke Patients - a Multi-center Audit Addressing a) Intracerebral Haemorrhage and b) Acute Ischemic Stroke in Patients Treated With Oral Anticoagulants

Typeobservational_patient_registrySponsorUniversity Hospital, Basel, SwitzerlandRan2014 to 2021Enrolled1,050ConditionsIschemic Stroke, Intracranial Hemorrhages
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
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

15 authors at 3 institutions in 1 country.

Fabian SchaubDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0002-2434-6423
Alexandros A PolymerisDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0002-9475-2208
Sabine SchaedelinClinical Trial Unit University of Basel Switzerland.
Lisa HertDepartment of Intensive Care Medicine University Hospital Basel Basel Switzerland.ORCID 0000-0002-6373-3928
Louisa MeyaDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0002-3017-0778
Sebastian ThilemannDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0002-2735-0794
Christopher TraenkaDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.
Benjamin WagnerDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0001-9330-1790
David SeiffgeDepartment of Neurology and Stroke Center University Hospital Bern Bern Switzerland.ORCID 0000-0003-3890-3849
Henrik GensickeDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0002-0949-2422
Gian Marco De MarchisDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0002-0342-9780
Leo BonatiDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0003-1163-8133
Stefan T EngelterDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0003-3855-6234
Nils PetersDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0001-8451-7389
Philippe LyrerDepartment of Neurology and Stroke Center University Hospital Basel and University of Basel Basel Switzerland.ORCID 0000-0002-1435-1114
University of Basel · CHUniversity Hospital of Basel · CHUniversity Hospital of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Data on the relative contribution of clinical and neuroimaging risk factors to acute ischemic stroke (AIS) versus intracerebral hemorrhage (ICH) occurring on oral anticoagulant treatment are scarce. Methods and Results Cross-sectional study was done on consecutive oral anticoagulant-treated patients presenting with AIS, transient ischemic attack (TIA), or ICH from the prospective observational NOACISP (Novel-Oral-Anticoagulants-In-Stroke-Patients)-Acute registry. We compared clinical and neuroimaging characteristics (small vessel disease markers and atherosclerosis) in ICH versus AIS/TIA (reference) using logistic regression. Among 734 patients presenting with stroke on oral anticoagulant treatment (404 [55%] direct oral anticoagulants, 330 [45%] vitamin K antagonists), 605 patients (82%) had AIS/TIA and 129 (18%) had ICH. Prior AIS/TIA, coronary artery disease, dyslipidemia, and worse renal function were associated with AIS/TIA (adjusted odds ratio [aOR] [95% CI] 0.51 [0.32-0.82], 0.48 [0.26-0.86], 0.55 [0.34-0.89], and 0.82 [0.75-0.90] per 10 mL/min). Prior ICH, older age, higher admission blood pressure, and statin treatment were associated with ICH (aOR [95% CI] 6.33 [2.87-14.04], 1.37 [1.04-1.81] per 10 years, 1.19 [1.10-1.29] per 10 mm Hg, and 1.81 [1.09-3.03]). Cerebral microbleeds and moderate-to-severe white matter hyperintensities contributed more to ICH (aOR [95% CI] 2.77 [1.34-6.18], and 2.62 [1.28-5.63]). Aortic arch, common and internal carotid artery atherosclerosis, and internal carotid artery stenosis ≥50% contributed more to AIS/TIA (aOR [95% CI] 0.54 [0.31-0.90], 0.29 [0.05-0.97], 0.48 [0.30-0.76], and 0.32 [0.13-0.67]). Conclusions In patients presenting with stroke on oral anticoagulant, AIS/TIA was 5 times more common than ICH. A high atherosclerotic burden (indicated by cardiovascular comorbidities and extracranial atherosclerosis) and prior AIS/TIA contributed more to AIS/TIA, while small vessel disease markers and prior ICH were stronger determinants for ICH. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02353585.

Indexed as

AtherosclerosisIschemic Attack, TransientIschemic StrokeStrokeAnticoagulantsCerebral HemorrhageCross-Sectional StudiesHumansAnticoagulantsatherosclerosisintracerebral hemorrhageischemic strokeoral anticoagulantssmall vessel disease

Identifiers

PMID34935409
PMCPMC9075191
OpenAlexW4200138371

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.