Evidence map›Paper›PMID 38161290›Full record

ArticleEuropean stroke journal2024

Risk of stroke in patients with prior VKA or DOAC: A population-based real-world registry analysis.

Lukas Mayer-Suess, Heinrich Rinner, Wilfried Lang, Stefan Greisenegger, Dominika Mikšová, Thomas Gattringer, Christian Enzigner, Marek Sykora, Milan Vosko, Johannes S Mutzenbach and 4 more

Open access · hybridAbstract read
In one paragraph

Article in European stroke journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. 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

14 authors at 8 institutions in 1 country.

Lukas Mayer-SuessDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0002-2856-0101
Heinrich RinnerTyrolean Health Care Fund, Innsbruck, Austria.
Wilfried LangDepartment of Neurology, Hospital Barmherzige Brüder Vienna, Vienna, Austria.
Stefan GreiseneggerDepartment of Neurology, Medical University of Vienna, Vienna, Austria.
Dominika MikšováAustrian National Public Health Institute/Austrian National Institute for Quality in Health Care, Vienna, Austria.
Thomas GattringerDepartment of Neurology, Medical University of Graz, Graz, Austria.
Christian EnzignerDepartment of Neurology, Medical University of Graz, Graz, Austria.
Marek SykoraDepartment of Neurology, Hospital Barmherzige Brüder Vienna, Vienna, Austria.
Milan VoskoDepartment of Neurology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Austria.
Johannes S MutzenbachDepartment of Neurology, Medical University of Salzburg, Salzburg, Austria.
Julia FerrariDepartment of Neurology, Hospital Barmherzige Brüder Vienna, Vienna, Austria.
Stefan KiechlDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Michael KnoflachDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Tyrolean Stroke Pathway group and the Austrian Stroke Unit Registry Collaborators
Convent Hospital of the Brothers of Saint John of God · ATInnsbruck Medical University · ATMedical University of Graz · ATGesundheit Österreich · ATJohannes Kepler University of Linz · ATMedical University of Vienna · ATTyrolean Cancer Research Institute · ATUniversity of Salzburg · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTo date, risk assessment of suffering ischemic and hemorrhagic stroke in individuals under oral anticoagulation (OAC) is limited to hospital-based cohorts and patients with atrial fibrillation. PATIENTS AND

methodsThrough the combination of three individual datasets, (1) the population-based Tyrolean Stroke Pathway database, prospectively documenting all (unselected) stroke patients in the entire federal state of the Tyrol and (2) nation-wide prescription data, detailing each reimbursed prescription in Austria as well as (3) the Austrian Stroke Unit Registry, a nation-wide registry comprising data on all patients admitted to any of the 38 stroke units in Austria, we assessed risk of stroke in patients with prior oral anticoagulation and compared characteristics of patients taking direct oral anticoagulants and Vitamin-K-Antagonists.

resultsIn Austria, oral anticoagulant prescription reimbursements increased from 292,475 in 2015 to 389,407 in 2021. In the Tyrol, prior oral anticoagulation treatment was evident in 586 of 3861 (15.2%) patients with ischemic and 131 of 523 (25.0%) with hemorrhagic stroke, with 20% and 35% of those stroke patients respectively having prior oral anticoagulation due to other indications than non-valvular atrial fibrillation. Considering prescription rates, treatment with direct oral anticoagulants was associated with a reduced stroke risk compared to Vitamin-K-Antagonists, especially in ischemic (1.05% vs 0.62%; RR 0.59, DISCUSSION AND

conclusionsOne in seven patients suffering ischemic and one in four suffering hemorrhagic stroke had prior oral anticoagulation treatment. Both ischemic and hemorrhagic strokes are less frequent in those with direct oral anticoagulant intake compared to those taking Vitamin-K-Antagonists. Establishment of clear standard operating procedures on how to best care for acute stroke patients with oral anticoagulation is essential.

Indexed as

AnticoagulantsAtrial FibrillationRegistriesStrokeAdministration, OralAgedAged, 80 and overAustriaFactor Xa InhibitorsFemaleHemorrhagic StrokeHumansIschemic StrokeMaleMiddle AgedRisk AssessmentAnticoagulantsFactor Xa InhibitorsVitamin KAnticoagulationDOACintracerebral hemorrhagestrokeVKA

Identifiers

PMID38161290
PMCPMC11318413
OpenAlexW4390484433

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.