Evidence map›Paper›PMID 36731927›Full record

ArticleBMJ open2023

Neurology care and the long-term outcomes of atrial fibrillation-related ischaemic stroke in China: median 3-year outcome from a high volume academic tertiary hospital.

Zidun Wang, Nan Wu, Fengming Wu, Lian Zhang, Xiaoyuan Gao, Yilan Yang, Mingfang Li, Qi Wan, Minglong Chen

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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3 · Its place in the literature

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0 citing papers in PubMed, 0 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Zidun Wang *Division of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Nan Wu *Gusu School,Nanjing Medical University, Nanjing, China.
Fengming WuDivision of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Lian ZhangDivision of Neurology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Xiaoyuan GaoDivision of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Yilan YangDivision of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Mingfang LiDivision of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Qi WanDivision of Neurology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Minglong ChenDivision of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China chenminglong@njmu.edu.cn.ORCID 0000-0002-9844-486X
Jiangsu Province Hospital · CNNanjing Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe initial medical contact of patients with atrial fibrillation (AF) and ischaemic stroke is often performed by neurologists. However, when stand care with oral anticoagulants (OACs) adherence and persistence was emphasised by cardiologists, data regarding the gap between current neurology care and standard care from Chinese tertiary hospitals is scarce and the long-term outcome is unknown. This study was to investigate the AF detection rate, the use of anticoagulation therapy and posthospital clinical outcomes associated with neurology care in patients with AF and ischaemic stroke in China.

designA retrospective cohort study.

settingClinical data of all patients who had an ischaemic stroke discharged from the neurologic department of a high-volume academic hospital from 1 January 2013 to 31 December 2017 were analysed and patients were followed.

participantsPatients diagnosed with ischaemic stroke and AF were included.

main outcome measuresThe usage of anticoagulation at discharge, the posthospital restroke rate and all-cause mortality.

resultsAmong 5797 patients who had an ischaemic stroke, 373 (6.43%) patients were diagnosed with AF during hospitalisation. Among them, only 198 (53.66%) patients were on anticoagulation therapy at discharge. A total of 325 (88.08%) patients were accessible and received follow-up. After a median 3-year follow-up, 103 (31.69%) patients died due to all causes. Among them, 53 (16.31%) patients died from recurrent stroke. And 86 (26.46%) patients restroked. In multivariable analysis, patients without anticoagulation therapy, muscle strength<grade 3 at discharge, coronary artery disease and advanced age predicted the recurrent stroke.

conclusionsSecondary stroke prevention in AF patients associated with neurology care is challenging in China, as manifested by a lower AF detection rate, significant underuse of OACs, high mortality and recurrent stroke rate. Efforts to increasing the AF detection rate and reinforce education on neurologists should be made to improve neurology care and intensify posthospital management in such patients.

Indexed as

Atrial FibrillationBrain IschemiaIschemic StrokeNeurologyStrokeAdministration, OralAnticoagulantsHumansRetrospective StudiesRisk FactorsTertiary Care CentersAnticoagulantsmedical education & trainingpacing & electrophysiologypublic healthstroke

Identifiers

PMID36731927
PMCPMC9896235
OpenAlexW4318986969

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