Evidence map›Paper›PMID 37959331›Full record

ArticleJournal of clinical medicine2023

The Role of Extracellular Matrix and Inflammation in the Stratification of Bleeding and Thrombotic Risk of Atrial Fibrillation on Oral Anticoagulant Therapy: Insights from Strat-Af Study.

Francesco Alfano, Francesca Cesari, Anna Maria Gori, Martina Berteotti, Emilia Salvadori, Betti Giusti, Alessia Bertelli, Ada Kura, Carmen Barbato, Benedetta Formelli and 7 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 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
0.8field-weighted citation impact, top 25% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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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

17 authors at 4 institutions in 1 country.

Francesco AlfanoDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
Francesca CesariDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
Anna Maria GoriDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
Martina BerteottiDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.ORCID 0000-0001-8281-4734
Emilia SalvadoriNEUROFARBA Department, Neuroscience Section, University of Florence, 50134 Florence, Italy.ORCID 0000-0003-0404-0053
Betti GiustiDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.ORCID 0000-0002-8708-9444
Alessia BertelliDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.ORCID 0000-0003-2482-6045
Ada KuraDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
Carmen BarbatoNEUROFARBA Department, Neuroscience Section, University of Florence, 50134 Florence, Italy.ORCID 0000-0003-4900-5008
Benedetta FormelliNEUROFARBA Department, Neuroscience Section, University of Florence, 50134 Florence, Italy.
Francesca PesciniStroke Unit, Careggi University Hospital, 50134 Florence, Italy.ORCID 0000-0003-4565-5601
Enrico FainardiNeuroradiology Unit, Careggi University Hospital, Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy.
Stefano ChitiHealth Physics Unit, Careggi University Hospital, 50134 Florence, Italy.
Chiara MarziInstitute of Applied Physics "Nello Carrara" (IFAC), National Research Council of Italy (CNR), 50019 Sesto Fiorentino, Italy.ORCID 0000-0002-1791-3573
Stefano DiciottiDepartment of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, 40126 Bologna, Italy.ORCID 0000-0001-8778-7819
Rossella MarcucciDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
Anna PoggesiNEUROFARBA Department, Neuroscience Section, University of Florence, 50134 Florence, Italy.ORCID 0000-0002-8694-0129
Azienda Ospedaliero-Universitaria Careggi · ITUniversity of Florence · ITMarconi University · ITNello Carrara Institute of Applied Physics · IT

Funding

Ministero della Salute GR-2013-02355523
6 · The paper itself

Abstract

In anticoagulated atrial fibrillation (AF) patients, the validity of models recommended for the stratification of the risk ratio between benefits and hemorrhage risk is limited. We hypothesize that both circulating and neuroimaging-based markers might improve the prediction of bleeding and thrombotic risk in anticoagulated AF patients. The Strat-AF study is an observational, prospective, single-center study enrolling 170 patients with AF; recruited patients are evaluated by means of a comprehensive protocol, with clinical, cerebral magnetic resonance imaging and circulating biomarkers assessment. The main outcome is the evaluation of cerebral microangiopathy related to the levels of circulating biomarkers of inflammation and extracellular matrix (ECM) remodeling. At multivariate logistic regression analysis adjusted for age, sex, CHA2DS2-VASc, HAS-BLED and type of anticoagulant, matrix metalloproteinases (MMP)-2 levels were significantly and positively associated with the presence of cerebral microbleeds (CMBs). A significant association between MMP-2, tissue inhibitor of metalloproteinases (TIMP)-1,-2,-4 levels and white matter hyperintensity was also found. Concerning the small vessel disease (SVD) score, MMP-2 and TIMP-1,-2 levels were associated with the presence of two and three or more signs of SVD, whereas TIMP-4 levels were associated with the presence of three signs of SVD with respect to patients with no instrumental signs of SVD. As regarding the presence of enlarged perivascular spaces (EPVS), a significant association was found for high levels of interleukin (IL)-8 and TIMP 1-2-3. These results demonstrate that patients with AF have evidence of impaired ECM degradation, which is an independent risk factor for thrombotic complications of AF patients on oral anticoagulant therapy. The incorporation of these markers in the prognostic schemes might improve their clinical capability in predicting stroke risk and thrombotic complications.

Indexed as

atrial fibrillationbiomarkerscerebral infarctscerebral microbleedsEPVSextracellular matrixhyperintensities of white matterSVDs

Identifiers

PMID37959331
PMCPMC10647302
OpenAlexW4388018003

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.