Evidence map›Paper›PMID 36692658›Full record

ArticleCardiovascular drugs and therapy2024

Antiplatelet Agents and Oral Anticoagulant Use in Patients with Atrial Fibrillation and Carotid Artery Disease After First-Time Ischaemic Stroke.

Stephanie L Harrison, Benjamin J R Buckley, Deirdre A Lane, Elnara Fazio-Eynullayeva, Paula Underhill, Andrew Hill, David J Werring, Gregory Y H Lip

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

Article in Cardiovascular drugs and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Combined antithrombotic therapy vs. oral anticoagulation alone for ischemic stroke with concomitant atrial fibrillation and large artery atherosclerosis: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Pooled it
  2. Article
  3. Atrial fibrillation: stroke prevention.The Lancet regional health. Europe · 2024
    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

8 authors at 3 institutions in 2 countries.

Stephanie L HarrisonLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, L7 8TX, Liverpool, UK. stephanie.harrison@liverpool.ac.uk.ORCID 0000-0002-8846-0946
Benjamin J R BuckleyLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, L7 8TX, Liverpool, UK.
Deirdre A LaneLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, L7 8TX, Liverpool, UK.
Elnara Fazio-EynullayevaTriNetX Inc., London, UK.
Paula UnderhillTriNetX Inc., London, UK.
Andrew HillDepartment of Medicine for Older People, Whiston Hospital, St Helens & Knowsley Teaching Hospitals NHS Trust, Prescot, UK.
David J WerringStroke Research Centre, UCL Queen Square Institute of Neurology, London, UK.
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, William Henry Duncan Building, L7 8TX, Liverpool, UK.
University of Liverpool · GBNational Hospital for Neurology and Neurosurgery · GBSt Helens and Knowsley Teaching Hospitals NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPeople with atrial fibrillation (AF) frequently have competing mechanisms for ischaemic stroke, including extracranial carotid atherosclerosis. The objective of this study was to determine associations between use of oral anticoagulants (OACs) plus antiplatelet agents (APA) after ischaemic stroke and outcomes for patients with AF and carotid artery disease. PATIENTS AND

methodsA retrospective cohort study was conducted. Participants receiving OACs with or without APA were propensity score-matched for age, sex, ethnicity, co-morbidities and presence of cardiac and vascular implants and grafts. Outcomes were 1-year mortality, recurrent stroke and major bleeding.

resultsOf 5708 patients, 24.1% (n=1628) received non-vitamin K antagonist OACs (NOACs) with no APA, 26.0% (n=1401) received NOACs plus APA, 20.7% (n=1243) received warfarin without APA and 29.2% (n=1436) received warfarin plus APA. There was no significant difference in risk of recurrent stroke between the groups. Compared to receiving NOACs without APA, receiving warfarin plus APA was associated with a higher risk of mortality (hazard ratio (HR) 1.51 (95% confidence interval (CI) 1.20, 1.89)) and major bleeding (HR 1.66 (95% CI 1.40, 1.96)). Receiving NOACs plus APA was also associated with a higher risk of major bleeding compared to NOACs without APA (HR 1.27 (95% CI 1.07, 1.51), respectively).

conclusionsThe results suggest for patients with AF and carotid artery disease after ischaemic stroke, receiving NOACs without APA is associated with a lower risk of major bleeding with no negative impact on recurrent stroke or mortality. Evidence from randomised trials is needed to confirm this finding.

Indexed as

AnticoagulantsAtrial FibrillationCarotid Artery DiseasesHemorrhageIschemic StrokePlatelet Aggregation InhibitorsAdministration, OralAgedAged, 80 and overDrug Therapy, CombinationFemaleHumansMaleMiddle AgedRecurrenceRetrospective StudiesAnticoagulantsPlatelet Aggregation InhibitorsWarfarinAnticoagulantsAntiplatelet agentsAtrial fibrillationCarotid artery diseaseStroke

Identifiers

PMID36692658
PMCPMC11266273
OpenAlexW4317871363

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.