Trial reportEuropean heart journal2023
Outcomes of patients with atrial fibrillation and ischemic stroke while on oral anticoagulation.
Trial report in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Clinical characteristics and outcomes of ischemic stroke despite appropriate oral anticoagulation for atrial fibrillation: A systematic review and meta-analysis of real-world studies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Residual Stroke Risk Among Patients With Atrial Fibrillation Prescribed Oral Anticoagulants: A Patient-Level Meta-Analysis From COMBINE AF.Journal of the American Heart Association · 2024Pooled it
- Recurrent Stroke Following Left Atrial Appendage Closure in Patients with Breakthrough Stroke: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Decoding the causes of ischemic stroke despite ongoing oral anticoagulation and their clinical impact: the ASPERA-R study.Journal of neurology · 2026Article
- Residual thromboembolic risk and outcomes of oral anticoagulation discontinuation after atrial fibrillation ablation: a target trial emulation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Factors associated with symptom relief and lesion formation in acute ischemic stroke and transient ischemic attack.BMC neurology · 2026Article
- Ischemic stroke prediction model of sick sinus syndrome patients without atrial fibrillation: insights from atrial myopathy.Scientific reports · 2026Article
- Update on left atrial appendage closure for neurologists.European stroke journal · 2026Review
- Targeted nanodelivery strategies for atrial fibrillation: concomitant targeting of fibrosis suppression and electrical conduction restoration through advanced nanobiotechnology.Journal of nanobiotechnology · 2025Review
- Article
- Percutaneous Left Atrial Appendage Closure in Patients With Cardioembolic Breakthrough Stroke: An International Observational Study.European journal of neurology · 2025Observational
- Residual risk prediction in anticoagulated patients with atrial fibrillation using machine learning: A report from the GLORIA-AF registry phase II/III.European journal of clinical investigation · 2025Article
- Left atrial appendage closure in patients with atrial fibrillation and acute ischaemic stroke despite anticoagulation.Stroke and vascular neurology · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- Decreased METTL3 in atrial myocytes promotes atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Clinical effects of acupuncture treatment for prevention of insomnia-induced stroke: A large-scale cohort study.Journal of traditional and complementary medicine · 2025Article
- The Impact of Changing Antithrombotic Management in Patients With Atrial Fibrillation and Ischemic Cerebrovascular Events Despite Anticoagulation.The Neurohospitalist · 2024Article
- Left Atrial Appendage Occlusion vs Standard of Care After Ischemic Stroke Despite Anticoagulation.JAMA neurology · 2024Article
- Keeping prior anticoagulation treatment in the acute phase of ischaemic stroke: the REKOALA study.Journal of neurology · 2024Article
- Left atrial appendage occlusion for recurrent stroke while on oral anticoagulation: a case series.European heart journal. Case reports · 2024Article
Corrections and comments
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Authors and funding
15 authors at 9 institutions in 5 countries.
Funding
Abstract
aimsThe prognosis of patients with atrial fibrillation (AF) and ischemic stroke while taking oral anticoagulation is poorly understood. This study aimed to characterize the outcomes of patients following a stroke event while on oral anticoagulation. METHODS AND
resultsIndividual participant data from five pivotal randomized trials of antithrombotic therapy in AF were used to assess the outcomes of patients with a post-randomization ischemic stroke while on study medication (warfarin, standard-, or lower-dose direct oral anticoagulant regimen) during trial follow-up. The primary outcome was recurrent ischemic stroke after the first post-randomization ischemic stroke. The primary analysis included 1163 patients with a first post-randomization ischemic stroke while on study medication (median age 73 years, 39.3% female, 35.4% history of stroke before trial enrollment). During a median continued follow-up of 337 days, 74 patients had a recurrent ischemic stroke [cumulative incidence at 1 year: 7.0%, 95% confidence interval (CI) 5.2%-8.7%]. The cumulative incidence of mortality at 3 months after stroke was 12.4% (95% CI 10.5%-14.4%). Consistent results for the incidence of recurrent ischemic stroke at 1 year were obtained in an analysis accounting for the competing risk of death (6.2%, 95% CI 4.8%-7.9%) and in a landmark analysis excluding the first 2 weeks after the index stroke and only including patients without permanent study drug discontinuation since then (6.8%, 95% CI 4.6%-8.9%).
conclusionPatients with AF and ischemic stroke while on oral anticoagulation are at increased risk of recurrent ischemic stroke and death. These patients currently have an unmet medical need.
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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.