Evidence map›Paper›PMID 39198185›Full record

ArticleJournal of atherosclerosis and thrombosis2025

Severity, Outcomes, and their Secular Changes in 33,870 Ischemic Stroke Patients with Atrial Fibrillation in a Hospital-Based Registry: Japan Stroke Data Bank.

Kazunori Toyoda, Sohei Yoshimura, Michikazu Nakai, Shinichi Wada, Kaori Miwa, Junpei Koge, Takashi Yoshida, Kenji Kamiyama, Tatsuya Mizoue, Taketo Hatano and 9 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of atherosclerosis and thrombosis, 2025. 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
–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

2 citing papers in PubMed.

  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

19 authors.

Kazunori ToyodaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Sohei YoshimuraDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Michikazu NakaiDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Shinichi WadaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Kaori MiwaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Junpei KogeDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Takashi YoshidaDepartment of Neurosurgery, Seijinkai Shimizu Hospital.
Kenji KamiyamaDepartment of Neurosurgery, Nakamura Memorial Hospital.
Tatsuya MizoueDepartment of Neurosurgery, Suiseikai Kajikawa Hospital.
Taketo HatanoDepartment of Neurosurgery, Kokura Memorial Hospital.
Yasuhisa YoshidaDepartment of Neurosurgery, Cerebrovascular Research Institute, Eishokai Yoshida Hospital.
Yusuke SasaharaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Akiko IshigamiDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Yoshitaka IwanagaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Yoshihiro MiyamotoDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center.
Kazuo MinematsuMedical Corporation Iseikai.
Shotai KobayashiShimane University School of Medicine, Izumo.
Masatoshi KogaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.
Japan Stroke Data Bank Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimSeverity, functional outcomes, and their secular changes in acute atrial fibrillation (AF)-associated stroke patients were determined.

methodsAcute ischemic stroke patients with AF in a hospital-based, multicenter, prospective registry from January-2000 through December-2020, were compared with those without AF. The co-primary outcomes were the initial severity assessed by the NIH Stroke Scale (NIHSS) score and favorable outcome assessed by the modified Rankin Scale scores 0-2 at hospital discharge.

resultsOf the 142,351 patients studied, 33,870 had AF. AF patients had higher NIHSS scores (median 9 vs. 3, adjusted coefficient 5.468, 95% CI 5.354-5.582) than non-AF patients. Favorable outcome was less common in AF patients than in non-AF patients in the unadjusted analysis (48.4% vs. 70.4%), but it was more common with adjustment for the NIHSS score and other factors (adjusted OR 1.110, 95% CI 1.061-1.161). In AF patients, the NIHSS score decreased throughout the 21-year period (adjusted coefficient -0.088, 95% CI -0.115 - -0.061 per year), and the reduction was steeper than in non-AF patients (P＜0.001). In AF patients, favorable outcome became more common over the period (adjusted OR 1.018, 95% CI 1.010-1.026), and the increase was steeper than in non-AF patients (P＜0.001); the increase was no longer significant after further adjustment by reperfusion therapy.

conclusionsInitial stroke severity became milder and functional outcomes improved in AF patients over the 21-year period. These secular changes were steeper than in non-AF patients, suggesting that AF-associated stroke seemed to reap more benefit of recent development of stroke care than stroke without AF.

Indexed as

Atrial FibrillationIschemic StrokeRegistriesAgedAged, 80 and overFemaleHumansJapanMaleMiddle AgedPrognosisProspective StudiesSeverity of Illness IndexAnticoagulationAtrial fibrillationCardioembolismReperfusion therapyStroke outcome

Identifiers

PMID39198185
PMCPMC11883203

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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.