Observational studyJournal of the American Heart Association2025
Prior Anticoagulation and Risk of Hemorrhagic Transformation in Acute Stroke: A Post Hoc Analysis of the PRODAST Study.
Observational study in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02507856 (Prospective Record Of the Use of Dabigatran in Patients With Acute Stroke or TIA), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Prospective Record Of the Use of Dabigatran in Patients With Acute Stroke or TIA
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Early versus late anticoagulation treatment after acute ischemic stroke with atrial fibrillation: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Impact of Pre-Existing and Newly Diagnosed Atrial Fibrillation on Clinical Outcomes of Patients with Ischaemic Stroke Undergoing Endovascular Thrombectomy: Analysis of Local Data.Journal of clinical medicine · 2026Article
- Real-world use and impact of direct oral anticoagulants among atrial fibrillation patients with cardioembolic stroke.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOral anticoagulation is highly effective in preventing ischemic events in patients with atrial fibrillation. Still, a considerable number of patients have an acute ischemic stroke or transient ischemic attack despite anticoagulation. In this study, we investigated the association of prior antithrombotic regimens with stroke severity, volume, and hemorrhagic transformation. METHODS AND
resultsThis is a post hoc analysis of the prospective, multicenter, observational PRODAST (Prospective Record of the Use of Dabigatran in Patients With Acute Stroke or TIA) study, which was conducted in 86 stroke units in Germany between July 2015 and November 2020. In 9030 patients with atrial fibrillation who had an acute ischemic stroke or transient ischemic attack within 7 days before enrollment, we analyzed the association of anticoagulants in comparison to lack of prevalent antithrombotic treatment with clinical stroke severity, infarct size, and risk for hemorrhagic transformation. A total of 4479 patients had prior anticoagulation at the time of index event. After adjustment for confounders (arterial hypertension, diabetes, heart failure, age, and sex), patients with prior anticoagulation had less severe strokes (-2.5 National Institutes of Health Stroke Scale points [95% CI, -2.8 to -2.2]), smaller infarct sizes (-23 mL [95% CI, -44 mL to -2 mL], n=4041), and reduced odds for hemorrhagic transformation (5% versus 10%; odds ratio, 0.48 [95% CI, 0.40-0.57]) compared with patients without antithrombotic treatment. These findings were confirmed using sensitivity analyses accounting for thrombolysis and mechanical thrombectomy, as well as timing of brain imaging. Antiplatelet therapy had hardly any association with the end points compared with no antithrombotic pretreatment.
conclusionsPrior anticoagulation was not only associated with less severe stroke and smaller infarct size but also with a reduced risk of hemorrhagic transformation compared with no antithrombotic pretreatment. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02507856.
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