Evidence map›Paper›PMID 36588887›Full record

ArticleFrontiers in neurology2022

Outcomes associated with antithrombotic strategies in heart failure with reduced ejection fraction and sinus rhythm following acute ischemic stroke.

Parth Patel, Justin Tiongson, Austin Chen, Taylor Siegal, Solomon Oak, Akhil Golla, Scott Kamen, Jesse M Thon, Nicholas Vigilante, Ameena Rana and 2 more

Open access · goldAbstract read
In one paragraph

Article in Frontiers in neurology, 2022. 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 37% 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. Review
  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

12 authors at 3 institutions in 1 country.

Parth PatelCooper Medical School of Rowan University, Camden, NJ, United States.
Justin TiongsonCooper Medical School of Rowan University, Camden, NJ, United States.
Austin ChenCooper Medical School of Rowan University, Camden, NJ, United States.
Taylor SiegalCooper Neurological Institute, Cooper University Hospital, Camden, NJ, United States.
Solomon OakCooper Medical School of Rowan University, Camden, NJ, United States.
Akhil GollaCooper Medical School of Rowan University, Camden, NJ, United States.
Scott KamenCooper Medical School of Rowan University, Camden, NJ, United States.
Jesse M ThonCooper Medical School of Rowan University, Camden, NJ, United States.
Nicholas VigilanteCooper Medical School of Rowan University, Camden, NJ, United States.
Ameena RanaDepartment of Neurology, Sinai Beth Israel Hospital, New York, NY, United States.
Taryn HesterCooper Neurological Institute, Cooper University Hospital, Camden, NJ, United States.
James E SieglerCooper Medical School of Rowan University, Camden, NJ, United States.
Cooper Medical School of Rowan University · USCooper University Hospital · USMount Sinai Beth Israel · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Insufficient data exist regarding the benefit of long-term antiplatelet vs. anticoagulant therapy in the prevention of recurrent ischemic stroke in patients with ischemic stroke and heart failure with reduced ejection fraction (HFrEF). Therefore, this study aimed to compare longitudinal outcomes associated with antiplatelet vs. anticoagulant use in a cohort of patients with stroke and with an ejection fraction of ≤40%. Methods: We retrospectively analyzed single-center registry data (2015-2021) of patients with ischemic stroke, HFrEF, and sinus rhythm. Time to the primary outcome of recurrent ischemic stroke, major bleeding, or death was assessed using the adjusted Cox proportional hazards model and was compared between patients treated using anticoagulation (±antiplatelet) vs. antiplatelet therapy alone after propensity score matching using an intention-to-treat (ITT) approach, with adjustment for residual measurable confounders. Sensitivity analyses included the multivariable Cox proportional hazards model using ITT and as-treated approaches without propensity score matching. Results: Of 2,974 screened patients, 217 were included in the secondary analyses, with 130 patients matched according to the propensity score for receiving anticoagulation treatment for the primary analysis, spanning 143 patient-years of follow-up. After propensity score matching, there was no significant association between anticoagulation and the primary outcome [hazard ratio (HR) 1.10, 95% confidence interval (CI): 0.56-2.17]. Non-White race (HR 2.26, 95% CI: 1.16-4.41) and the presence of intracranial occlusion (HR 2.86, 95% CI: 1.40-5.83) were independently associated with the primary outcome, while hypertension was inversely associated (HR 0.42, 95% CI: 0.21-0.84). There remained no significant association between anticoagulation and the primary outcome in sensitivity analyses. Conclusion: In HFrEF patients with an acute stroke, there was no difference in outcomes of antithrombotic strategies. While this study was limited by non-randomized treatment allocation, the results support future trials of stroke patients with HFrEF which may randomize patients to anticoagulation or antiplatelet.

Indexed as

anticoagulantantiplateletembolismheart failurestroke

Identifiers

PMID36588887
PMCPMC9797677
OpenAlexW4311505381

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.