Evidence map›Paper›PMID 37548681›Full record

ArticleJournal of neurology2023

Left ventricular hypertrophy and left atrial size are associated with ischemic strokes among non-vitamin K antagonist oral anticoagulant users.

Alvin S Das, Elif Gökçal, Avia Abramovitz Fouks, Mitchell J Horn, Robert W Regenhardt, Anand Viswanathan, Aneesh B Singhal, Lee H Schwamm, Steven M Greenberg, M Edip Gurol

Open access · greenAbstract 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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 33% 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

0 citing papers in PubMed, 2 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

10 authors at 2 institutions in 1 country.

Alvin S DasDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. adas4@bidmc.harvard.edu.ORCID http://orcid.org/0000-0003-2313-977X
Elif GökçalDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Avia Abramovitz FouksDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Mitchell J HornDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Robert W RegenhardtDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0003-2958-3484
Anand ViswanathanDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Aneesh B SinghalDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Lee H SchwammDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Steven M GreenbergDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
M Edip GurolDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Harvard University · USBeth Israel Deaconess Medical Center · US

Funding

Vascular Dysfunction in Cerebral Amyloid AngiopathyR01AG026484 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI GREENBERG, STEVEN M · 2005 to 2019
$7.5M
CEREBRAL AMYLOID ANGIOPATHY AND MECHANISMS OF BRAIN AMYLOID ACCUMULATIONR01NS096730 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI BACSKAI, BRIAN J, GREENBERG, STEVEN M · 2016 to 2020
$5.7M
Molecular and Physiological Mechanisms of Hypertensive Cerebral MicroangiopathyR01NS114526 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GUROL, MAHMUT EDIP · 2020 to 2024
$4.4M
Molecular Neuroimaging of Disease Mechanisms in Cerebral Amyloid AngiopathyK23NS083711 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GUROL, MAHMUT EDIP · 2014 to 2018
$988k
NIA NIH HHS R01 AG026484NINDS NIH HHS 5R01AG026484NINDS NIH HHS 5R01NS096730-04NINDS NIH HHS K23 NS083711NINDS NIH HHS NS083711NINDS NIH HHS R01 NS096730NINDS NIH HHS R01 NS114526NINDS NIH HHS R01NS114526
6 · The paper itself

Abstract

backgroundIschemic strokes (IS) occurring in patients taking non-vitamin K antagonist oral anticoagulants (NOACs) are becoming increasingly more frequent. We aimed to determine the clinical, echocardiographic, and neuroimaging markers associated with developing IS in patients taking NOACs for atrial fibrillation.

methodsFrom a quaternary care center, clinical/radiologic data were collected from consecutive NOAC users with IS and age-matched controls without IS. Brain MRIs were reviewed for markers of cerebral small vessel disease. Variables with significant differences between groups were entered into a multivariable regression model to determine predictors of IS. Among IS patients, a Cox regression analysis was constructed to determine predictors of IS recurrence during follow-up.

results112 patients with IS and 94 controls were included in the study. Variables significantly different between groups included apixaban use, dabigatran use, prior cerebrovascular events, hemoglobin A1c (HbA1c), left ventricular hypertrophy, left atrial volume index, and severe white matter hyperintensities. After multivariable adjustment, prior cerebrovascular events (aOR 23.86, 95% CI [6.02-94.48]), HbA1c levels (aOR 2.36, 95% CI [1.39-3.99]), left ventricular hypertrophy (aOR 2.73, 95% CI [1.11-6.71]) and left atrial volume index (aOR 1.05, 95% CI [1.01-1.08]) increased the risk of stroke, whereas apixaban use appeared to decrease the risk (aOR 0.38, 95% CI [0.16-0.92]). Malignancy was associated with IS recurrence (aHR 4.90, 95% CI [1.35-18.42]) after adjustment for age and chronic renal failure.

conclusionsPrior cerebrovascular events, diabetes, left ventricular hypertrophy, and increased left atrial size are risk factors for developing an IS among NOAC users.

Indexed as

Atrial FibrillationIschemic StrokeStrokeAdministration, OralAnticoagulantsGlycated HemoglobinHeart AtriaHumansHypertrophy, Left VentricularAnticoagulantsGlycated HemoglobinAtrial fibrillationCerebral infarctionIschemic strokeMRIOral anticoagulation

Identifiers

PMID37548681
PMCPMC11111216
OpenAlexW4385619681

What OpenQuestion holds

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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.