Evidence map›Paper›PMID 39716815›Full record

SynthesisClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

Optimal Antithrombotic Regimen After Cryptogenic Stroke: A Systematic Review and Network Meta-Analysis.

Mohamed Abuelazm, Ahmed Mazen Amin, Hossam Tharwat Ali, Mohammed Ayyad, Abubakar Nazir, Mohammad Tanashat, Shrouk Ramadan, Basel Abdelazeem, James Robert Brašić

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

9 authors.

Mohamed AbuelazmFaculty of Medicine, Tanta University, Tanta, Egypt.
Ahmed Mazen AminFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Hossam Tharwat AliFaculty of Medicine, Qena Faculty of Medicine, South Valley University, Qena, Egypt.
Mohammed AyyadDepartment of Internal Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
Abubakar NazirDepartment of Medicine, King Edward Medical University, Lahore, Pakistan.ORCID 0000-0002-6650-6982
Mohammad TanashatFaculty of Medicine, Yarmouk University, Irbid, Jordan.
Shrouk RamadanFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Basel AbdelazeemCardiology Department, West Virginia University, Morgantown, West Virginia, USA.
James Robert BrašićDepartment of Psychiatry, New York City Health and Hospitals/Bellevue, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although several antithrombotic strategies have been investigated for the management of cryptogenic strokes, ie, ischemic strokes without known etiologies, an optimal antithrombotic strategy for cryptogenic strokes is unknown. We aim to assess oral antithrombotic agents' comparative efficacy and safety after cryptogenic stroke to identify an optimal treatment.A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Embase Cochrane, Scopus, and Web of Science until February 2024. We used the random-effects model to report dichotomous outcomes using a risk ratio (RR) with a 95% confidence interval (CI). Frequentist network meta-analysis was conducted using R, version 4.3.1.Seven RCTs with 15,240 patients were included. None of the OACs showed a significant efficacy in preventing all-cause mortality, stroke recurrence, cardiovascular mortality, and major adverse cardiac events compared to aspirin. Also, safety measures were similar between different OACs and aspirin regarding safety measures, including major bleeding, intracranial hemorrhage, and gastrointestinal bleeding. However, only rivaroxaban significantly increased the incidence of major bleeding (RR: 2.69, CI [1.67, 4.33]).There was no difference between various OACs and aspirin regarding efficacy and safety outcomes. There is a greater risk of major bleeding with rivaroxaban. Further research is still warranted to define a personalized strategy for selecting antithrombotic strategies after cryptogenic stroke on a case-by-case basis.

Indexed as

Fibrinolytic AgentsIschemic StrokeHumansStrokeFibrinolytic Agentsapixabanaspirinbrain infarctdabigatranESUSidiopathicrivaroxabanwarfarin

Identifiers

PMID39716815
PMCPMC11672598

What OpenQuestion holds

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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.