Evidence map›Paper›PMID 38299346›Full record

Trial reportStroke2024

Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis.

William Harris, Jed H Kaiser, Vanessa Liao, Radhika Avadhani, Costantino Iadecola, Guido J Falcone, Kevin N Sheth, Adnan I Qureshi, Joshua N Goldstein, Issam A Awad and 4 more

Open access · bronzeAbstract readClinical Trial, Phase III
In one paragraph

Trial report in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 24% 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, 3 citations in OpenAlex.

  1. Article
  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 6 institutions in 1 country.

William HarrisClinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY (W.H., J.H.K., V.L., C.I., H.K., S.B.M.).ORCID 0000-0001-8103-9465
Jed H KaiserClinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY (W.H., J.H.K., V.L., C.I., H.K., S.B.M.).ORCID 0000-0003-4955-8606
Vanessa LiaoClinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY (W.H., J.H.K., V.L., C.I., H.K., S.B.M.).
Radhika AvadhaniBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD (R.A., D.F.H., W.C.Z.).
Costantino IadecolaClinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY (W.H., J.H.K., V.L., C.I., H.K., S.B.M.).ORCID 0000-0001-9797-073X
Guido J FalconeDivision of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale University School of Medicine, New Haven, CT (G.J.F., K.N.S.).ORCID 0000-0002-6407-0302
Kevin N ShethDivision of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale University School of Medicine, New Haven, CT (G.J.F., K.N.S.).ORCID 0000-0003-2003-5473
Adnan I QureshiZeenat Qureshi Stroke Institutes and Department of Neurology, University of Missouri, Columbia (A.I.Q.).ORCID 0000-0003-4962-540X
Joshua N GoldsteinDepartment of Emergency Medicine, Massachusetts General Hospital, Boston (J.N.G.).ORCID 0000-0002-6406-1828
Issam A AwadDepartment of Neurological Surgery, University of Chicago, IL (I.A.A.).ORCID 0000-0003-1510-602X
Daniel F HanleyBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD (R.A., D.F.H., W.C.Z.).ORCID 0000-0002-9536-4258
Hooman KamelClinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY (W.H., J.H.K., V.L., C.I., H.K., S.B.M.).ORCID 0000-0002-5745-0307
Wendy C ZiaiBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD (R.A., D.F.H., W.C.Z.).ORCID 0000-0003-4548-7353
Santosh B MurthyClinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY (W.H., J.H.K., V.L., C.I., H.K., S.B.M.).ORCID 0000-0002-4950-0992
Cornell University · USJohns Hopkins University · USYale University · USAnna Needs Neuroblastoma Answers · USCentraCare Health System · USMassachusetts General Hospital · US

Funding

MISTIE III_ Lead Grant_ Cluster Application for the Clinical Coordinating CenterU01NS080824 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2013 to 2017
$23.2M
AtRial Cardiopathy and Antithrombotic Drugs In prevention After cryptogenicstroke (ARCADIA)U01NS095869 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BRODERICK, JOSEPH PAUL, KAMEL, HOOMAN · 2017 to 2022
$22.0M
Anticoagulation in ICH Survivors for Prevention and Recovery (ASPIRE)U01NS106513 · NINDS · YALE UNIVERSITY · PI Hooman Kamel, Kevin Navin Sheth · 2019 to 2026
$20.6M
Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-II)U01NS062091 · NINDS · UNIVERSITY OF MINNESOTA · PI QURESHI, ADNAN IQBAL · 2010 to 2014
$18.1M
MRI Detection of CarotId Plaques as a mecHanism for Embolic strokes of undeteRmined source (MRI DECIPHER)R01HL144541 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI GUPTA, AJAY, KAMEL, HOOMAN · 2019 to 2023
$3.9M
Quantitative Susceptibility Mapping for Stroke Risk Prediction of Vulnerable Carotid PlaquesR01NS123576 · NINDS · WEILL MEDICAL COLL OF CORNELL UNIV · PI Ajay Gupta, Hooman Kamel · 2022 to 2026
$3.3M
SCORE-IT: The CTA Spot Sign Score in Acute Cerebral HemorrhageR01NS073344 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI ROSAND, JONATHAN · 2011 to 2015
$2.2M
Intracerebral Hemorrhage and Increased Risk of Arterial ThromboembolismK23NS105948 · NINDS · WEILL MEDICAL COLL OF CORNELL UNIV · PI MURTHY, SANTOSH BHASKAR · 2018 to 2022
$972k
NHLBI NIH HHS R01 HL144541NINDS NIH HHS K23 NS105948NINDS NIH HHS R01 NS073344NINDS NIH HHS R01 NS123576NINDS NIH HHS U01 NS062091NINDS NIH HHS U01 NS080824NINDS NIH HHS U01 NS095869NINDS NIH HHS U01 NS106513
6 · The paper itself

Abstract

backgroundNontraumatic intracerebral hemorrhage (ICH) is independently associated with a long-term increased risk of major arterial ischemic events. While the relationship between ICH location and ischemic risk has been studied, whether hematoma volume influences this risk is poorly understood.

methodsWe pooled individual patient data from the MISTIE III (Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation Phase 3) and the ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage-2) trials. The exposure was hematoma volume, treated as a continuous measure in the primary analysis, and dichotomized by the median in the secondary analyses. The outcome was a symptomatic, clinically overt ischemic stroke, adjudicated centrally within each trial. We evaluated the association between hematoma volume and the risk of an ischemic stroke using Cox regression analyses after adjustment for demographics, vascular comorbidities, and ICH characteristics.

resultsOf 1470 patients with ICH, the mean age was 61.7 (SD, 12.8) years, and 574 (38.3%) were female. The median hematoma volume was 17.3 mL (interquartile range, 7.2-35.7). During a median follow-up of 107 days (interquartile range, 91-140), a total of 30 ischemic strokes occurred, of which 22 were in patients with a median ICH volume of ≥17.3 mL and a cumulative incidence of 4.6% (95% CI, 3.1-7.1). Among patients with a median ICH volume <17.3 mL, there were 8 ischemic strokes with a cumulative incidence of 3.1% (95% CI, 1.7-6.0). In primary analyses using adjusted Cox regression models, ICH volume was associated with an increased risk of ischemic stroke (hazard ratio, 1.02 per mL increase [95% CI, 1.01-1.04]). In secondary analyses, ICH volume of ≥17.3 mL was associated with an increased risk of ischemic stroke (hazard ratio, 2.5 [95% CI, 1.1-7.2]), compared with those with an ICH volume <17.3 mL.

conclusionsIn a heterogeneous cohort of patients with ICH, initial hematoma volume was associated with a heightened short-term risk of ischemic stroke.

Indexed as

Ischemic StrokeStrokeAntihypertensive AgentsCerebral HemorrhageFemaleHematomaHumansMaleMiddle AgedTissue Plasminogen ActivatorTreatment OutcomeAntihypertensive AgentsTissue Plasminogen Activatorantihypertensive agentscerebral hemorrhagehematomaischemic strokeregression analyses

Identifiers

PMID38299346
PMCPMC10932908
OpenAlexW4391439465

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.