Evidence map›Paper›PMID 36939933›Full record

ArticleJournal of neurology2023

Baseline brain imaging signs in patients with ischaemic stroke by the presence of atrial fibrillation: the ENCHANTED trial.

Xia Wang, Shoujiang You, Zien Zhou, Candice Delcourt, Joanna Wardlaw, Grant Mair, Thompson Robinson, Xiaoying Chen, Sohei Yoshimura, Takako Torii-Yoshimura and 4 more

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01422616 (An International Randomised Controlled Trial to Establish the Effects of Low-dose rtPA and the Effects of Early Intensive Blood Pressure Lowering in Patients With Acute Ischaemic Stroke), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 96% 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.

NCT01422616 phase3completednot on this map

An International Randomised Controlled Trial to Establish the Effects of Low-dose rtPA and the Effects of Early Intensive Blood Pressure Lowering in Patients With Acute Ischaemic Stroke

TypeinterventionalSponsorThe George InstituteRan2012 to 2018Enrolled4,587ConditionsIschemic Stroke, High Blood PressureArmsLow-dose rtPA, Standard-dose rtPA, Intensive blood pressure (BP) lowering, BP management policies
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

14 authors at 8 institutions in 4 countries.

Xia Wang *The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Shoujiang You *Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Zien ZhouThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Candice DelcourtThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Joanna WardlawEdinburgh Imaging, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Grant MairEdinburgh Imaging, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Thompson RobinsonDepartment of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
Xiaoying ChenThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Sohei YoshimuraThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Takako Torii-YoshimuraDivision of Neurology, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka, Japan.
Cheryl CarcelThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Alejandra MalaveraThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Craig AndersonThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Richard I LindleyThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia. richard.lindley@sydney.edu.au.ORCID http://orcid.org/0000-0002-0104-5679
UNSW Sydney · AUShanghai Jiao Tong University · CNNagoya City University · JPSoochow University · CNThe University of Sydney · AUUK Dementia Research Institute · GBUniversity of Edinburgh · GBUniversity of Leicester · GB

Funding

Medical Research Council MC_G1002455
6 · The paper itself

Abstract

backgroundWe aimed to assess the association of atrial fibrillation (AF) on outcomes in a post hoc analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) and how this association is modified by baseline imaging features.

methodsInverse probability of treatment weight was used to remove baseline imbalances between those with and without AF. The primary outcome was the modified Rankin Scale (mRS) scores at 90 days. Secondary outcomes were symptomatic intracerebral haemorrhage (sICH), early neurological deterioration or death within 24 h, and death at 90 days. The logistic regression model was used to determine the associations.

resultsOf the 3285 patients included in this analysis, 636 (19%) had AF at baseline. Compared with non-AF, AF was not significantly associated with an unfavourable shift of mRS (odds ratio 1.09; 95% confidence interval, 0.96-1.24), but with sICH (2.82; 1.78-4.48; IST-3 criteria), early neurological deterioration or death within 24 h (1.31; 1.01-1.70), and death (1.42; 1.12-1.79). Among patients with acute ischaemic signs (presence, extent, swelling and attenuation of acute lesions), AF was associated with the increased risk of all the poor outcomes (all P < 0.04 for interaction).

conclusionsWe found AF increased risk of sICH, early neurological deterioration or death and death, but not unfavourable functional recovery at day 90 after thrombolysis in patients with AIS. The presence of acute ischaemic brain imaging signs at stroke presentation could be used to improve risk stratification in the presence of AF.

trial registrationThe trial is registered at ClinicalTrials.gov (NCT01422616).

Indexed as

Atrial FibrillationBrain IschemiaIschemic StrokeStrokeCerebral HemorrhageFibrinolytic AgentsHumansNeuroimagingThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorAtrial fibrillationImaging signsIschaemic strokeThrombolysis

Identifiers

PMID36939933
PMCPMC10130001
OpenAlexW4327893925

What OpenQuestion holds

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LicenceCC BY
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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.