Evidence map›Paper›PMID 40774831›Full record

ArticleJournal of thrombosis and haemostasis : JTH2025

Circulating biomarkers and ischemic stroke risk in adults with atrial fibrillation taking anticoagulation: the Reasons for Geographic And Racial Differences in Stroke study.

Samuel A P Short, Erin Hald, Katherine Wilkinson, George Howard, Virginia Howard, Suzanne E Judd, Elsayed Z Soliman, Brett Kissela, David Robinson, Robert Stanton and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thrombosis and haemostasis : JTH, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Blood Biomarkers and the Risk of Coronary Disease in Atrial Fibrillation.Journal of the American Heart Association · 2026
    Article
  2. Article
  3. 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

11 authors.

Samuel A P ShortLarner College of Medicine, University of Vermont, Burlington, Vermont, USA.
Erin HaldDepartment of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA; Department of Medicine, The Arctic University of Norway, Trømso, Norway.
Katherine WilkinsonDepartment of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
George HowardDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Virginia HowardDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Suzanne E JuddDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Elsayed Z SolimanDepartment of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Brett KisselaDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
David RobinsonDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Robert StantonDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Mary CushmanDepartment of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA; Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA. Electronic address: Mary.Cushman@uvm.edu.

Funding

Vermont Center for Cardiovascular and Brain HealthP20GM135007 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI Kathryn H Morelli · 2020 to 2026
$17.4M
Understanding Cohort Effects on Stroke, VCID, and Cognition After Major Epidemiologic TransitionsRF1NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2024 to 2024
$16.2M
NIGMS NIH HHS P20 GM135007NINDS NIH HHS RF1 NS041588
6 · The paper itself

Abstract

backgroundAnticoagulation reduces ischemic stroke risk in atrial fibrillation (AF), but "breakthrough" stroke occurs. Blood biomarkers might help identify patients at risk for this, but existing studies are limited in examining few biomarkers in select populations.

objectivesTo determine whether established biomarkers of ischemic stroke risk will be associated with ischemic stroke risk in people with AF on anticoagulation sampled from the general population.

methodsThe REasons for Geographic and Racial Differences in Stroke study is a prospective cohort study of 30 239 Black or White adults aged ≥45 years at enrollment in 2003 to 2007 monitored for stroke. Nine biomarkers were measured at baseline in participants with AF, no prior stroke, and who were taking oral anticoagulation at baseline. Hazard ratios of ischemic stroke were estimated by Cox models adjusted for demographics and stroke risk factors.

resultsAmong 713 participants with AF on warfarin (median age 76, 36% female, 17% Black), 67 (9%) developed a first-time ischemic stroke over 12 years. Adjusting for confounders, each SD higher N-terminal pro-B-type natriuretic peptide (NTproBNP), factor VIII, D-dimer, and growth differentiation factor 15 (GDF-15) were positively associated with incident stroke, with hazard ratios ranging from 1.49 (95% CI, 1.11-2.02) for NTproBNP to 1.28 (95% CI, 0.92-1.77) for GDF-15. Associations for D-dimer and GDF-15 did not meet statistical significance.

conclusionBiomarkers of atriopathy, coagulation, and vascular inflammation were associated with higher ischemic stroke risk in people with AF on anticoagulation at baseline. Findings highlight new avenues for reducing stroke risk in AF, but a larger study is needed for validation.

Indexed as

AnticoagulantsAtrial FibrillationIschemic StrokeStrokeAgedAged, 80 and overBiomarkersBlack or African AmericanFactor VIIIFemaleFibrin Fibrinogen Degradation ProductsGrowth Differentiation Factor 15HumansMaleMiddle AgedNatriuretic Peptide, BrainAnticoagulantsBiomarkersFactor VIIIFibrin Fibrinogen Degradation Productsfibrin fragment DGDF15 protein, humanGrowth Differentiation Factor 15Natriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Warfarinanticoagulantatrial fibrillationbiomarkerscohort studyischemic stroke

Identifiers

PMID40774831
PMCPMC12931963

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.