Evidence map›Paper›PMID 36513036›Full record

Observational studyCerebrovascular diseases (Basel, Switzerland)2023

Global Cortical Atrophy Is Associated with an Unfavorable Outcome in Stroke Patients on Oral Anticoagulation.

Marta Kubacka, Annaelle Zietz, Sabine Schaedelin, Alexandros A Polymeris, Lisa Hert, Johanna Lieb, Benjamin Wagner, David Seiffge, Christopher Traenka, Valerian L Altersberger and 10 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Cerebrovascular diseases (Basel, Switzerland), 2023. 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 39% 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, 2 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

20 authors at 2 institutions in 1 country.

Marta KubackaStroke Center, Klinik Hirslanden, Zürich, Switzerland.
Annaelle ZietzDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland, annaelle.zietz@usb.ch.
Sabine SchaedelinClinical Trial Unit, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
Alexandros A PolymerisDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Lisa HertDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Johanna LiebDepartment of Neuroradiology, University Hospital Basel, Basel, Switzerland.
Benjamin WagnerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
David SeiffgeDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Christopher TraenkaDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Valerian L AltersbergerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Tolga DittrichDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Joachim FladtDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Urs FischDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Sebastian ThilemannDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Gian Marco De MarchisDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Henrik GensickeDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Leo H BonatiDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Philippe LyrerDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Stefan T EngelterDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
Nils PetersStroke Center, Klinik Hirslanden, Zürich, Switzerland.
University of Basel · CHUniversity Hospital of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMeasures of cerebral small vessel disease (cSVD), such as white matter hyperintensities (WMH) and cerebral microbleeds (CMB), are associated with an unfavorable clinical course in stroke patients on oral anticoagulation (OAC) for atrial fibrillation (AF). Here, we investigated whether similar findings can be observed for global cortical atrophy (GCA).

methodsRegistry-based prospective observational study of 320 patients treated with OAC following AF stroke. Patients underwent magnetic resonance imaging (MRI) allowing assessment of GCA. Using the simplified visual Pasquier scale, the severity of GCA was categorized as follows: 0: no atrophy, 1: mild atrophy; 2: moderate atrophy, and 3: severe atrophy. Using adjusted logistic and Cox regression analysis, we investigated the association of GCA using a composite outcome measure, comprising: (i) recurrent acute ischemic stroke (IS); (ii) intracranial hemorrhage (ICH); and (iii) death.

resultsIn our time to event analysis after adjusting for potential confounders (i.e., WMH, CMB, age, sex, diabetes, arterial hypertension, coronary heart disease, hyperlipidemia, and antiplatelet use), GCA was associated with an increased risk for the composite outcome in all three degrees of atrophy (grade 1: aHR 3.95, 95% CI 1.34-11.63, p = 0.013; grade 2: aHR 3.89, 95% CI 1.23-12.30, p = 0.021; grade 3: aHR 4.16, 95% CI 1.17-14.84, p = 0.028).

conclusionGCA was associated with our composite outcome also after adjusting for other cSVD markers (i.e., CMB, WMH) and age, indicating that GCA may potentially serve as a prognostic marker for stroke patients with atrial fibrillation on oral anticoagulation.

Indexed as

Atrial FibrillationIschemic StrokeStrokeAnticoagulantsAtrophyCerebral HemorrhageHumansAnticoagulantsAtrial fibrillationGlobal cortical atrophyIntracerebral hemorrhageSmall vessel diseaseStroke

Identifiers

PMID36513036
PMCPMC10627484
OpenAlexW4311271697

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.