Evidence map›Paper›PMID 41503592›Full record

ReviewInternational journal of cardiology. Cardiovascular risk and prevention2026

Relationship between stroke onset timing and clinical outcomes in ischemic and hemorrhagic strokes: a systematic review.

Paria Heidari, Negar Heidari, Habibolah Khazaie, Sabra Margaret Abbott, Azad Maroufi, Amir Abdolmaleki, Nader Salari, Masoud Mohammadi, Amir Sharafkhaneh

Abstract readReview
In one paragraph

Review in International journal of cardiology. Cardiovascular risk and prevention, 2026. 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. Review
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.

Paria HeidariStudent Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Negar HeidariSocial Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Habibolah KhazaieSleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Sabra Margaret AbbottNorthwestern Feinberg, School of Medicine, Chicago, IL, USA.
Azad MaroufiNeurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Amir AbdolmalekiDepartment of Operating Room, Nahavand School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
Nader SalariFertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Masoud MohammadiResearch Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
Amir SharafkhanehDepartment of Medicine, Pulmonary, Critical Medicine and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Cerebrovascular accident (CVA) is a critical medical pathology caused by the interruption of cerebral blood flow and leads to neuronal injury or neurodegeneration. Generally, CVAs are classified into two primary categories of ischemic and hemorrhagic. Investigation of circadian rhythm variation at the time of CVA onset is a critical subject for patient management, clinical treatment, and further scientific research. This systematic review aimed to investigate the relationship between the timing of stroke onset and patient outcomes in both ischemic and hemorrhagic strokes. Methods: Following searching strategy designation, international databases of Embase, PubMed, Scopus, WoS, ScienceDirect, and Google Scholar were searched using the MeSH-based keywords. No time restrictions were applied in this regard (by December 8, 2024). All English-based observational studies reporting the risk of CVA at various daytimes were enrolled for screenings and quality control. Finally, eligible studies were selected for data extraction and categorization. Results: According to the reports, ischemic strokes strictly occur in morning hours (06:00 to 12:00) while some studies recorded a bimodal pattern (dual peaks during morning and evening). It was also established that the strokes at night were more severe and yielded more unfavorable results. Scattered reports were found regarding the hemorrhagic strokes; some papers revealed the highest incidence in the early morning hours, while others reported the late evening or nighttime occurrence. In addition, some studies showed that nighttime hemorrhagic strokes are usually associated with greater severity and unfavorable clinical outcomes. Conclusion: This study clarified the effect of cyclic pattern on the incidence and outcome of stroke. These trends seem greatly accounted for improvement of prevention strategies, management of treatments, and enhancement of patient outcomes.

Indexed as

Hemorrhagic strokeIschemic strokeStroke outcomesSystematic review

Identifiers

PMID41503592
PMCPMC12769409

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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.