Evidence map›Paper›PMID 37471323›Full record

SynthesisPloS one2023

Effect of implantable cardiac monitors on preventing stroke: A systematic review and meta-analysis of randomized clinical trials.

Jialing He, Yaxin Jiang, Yangchun Xiao, Pengfei Hao, Tiangui Li, Liyuan Peng, Yuning Feng, Xin Cheng, Haidong Deng, Peng Wang and 8 more

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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. Observational
  2. Review
  3. Article
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

18 authors.

Jialing HeEvidence-Based Medicine Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.ORCID 0000-0001-8871-0012
Yaxin JiangDepartment of Out-patient, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Yangchun XiaoDepartment of Neurosurgery, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Pengfei HaoDepartment of Neurosurgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
Tiangui LiDepartment of Neurosurgery, Longquan Hospital, Chengdu, Sichuan, China.
Liyuan PengDepartment of Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Yuning FengDepartment of orthopedics, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Xin ChengDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Haidong DengEvidence-Based Medicine Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Peng WangEvidence-Based Medicine Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Weelic ChongDepartment of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States of America.
Yang HaiSidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America.
Lvlin ChenEvidence-Based Medicine Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Chao YouDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Lu JiaDepartment of Neurosurgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
Fang FangDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Shui YuSidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America.
Yu ZhangEvidence-Based Medicine Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.ORCID 0000-0002-4714-2167

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimImplantable cardiac monitors (ICM) can facilitate the detection of asymptomatic atrial fibrillation episodes. We performed a systematic review and meta-analysis to investigate whether ICM can prevent stroke in patients with prior stroke and risk factors for stroke.

methodsThis study included randomized controlled trials comparing ICM with conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. We searched Medline, Embase, and CENTRAL from inception until January 5, 2022, without language restriction. Quantitative pooling of the data was undertaken using a random-effects model. The primary outcome was ischemic stroke at the longest follow-up.

resultsFour trials comprising 7237 patients were included. ICM was significantly associated with decreased risk of ischemic stroke (RR 0.76; 95% CI, 0.59-0.97; moderate-quality evidence) in patients with prior stroke and risk factors for stroke. ICM was associated with higher detection of atrial fibrillation (RR 4.21, 95% CI 2.26-7.85) and use of oral anticoagulants (RR 2.29, 95% CI 2.07-2.55).

conclusionsICM results in a significantly lower risk of ischemic stroke than conventional (non-ICM) external cardiac monitoring in patients with prior stroke and risk factors for stroke. Due to the clinical heterogeneity of study population and limited related studies, more trials were needed to furtherly explore the topic in patients with prior stroke or high risk of stroke.

Indexed as

Atrial FibrillationIschemic StrokeStrokeAnticoagulantsElectrocardiographyHumansRandomized Controlled Trials as TopicAnticoagulants

Identifiers

PMID37471323
PMCPMC10358888

What OpenQuestion holds

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Registered trials

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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.