ArticleBMJ open2026
Association of ischaemic stroke/TIA with subsequent oral anticoagulant adherence in patients with atrial fibrillation: a scoping review.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
Funding
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Abstract
objectivesThis study aimed to investigate the association and potential causal relationship between ischaemic stroke/transient ischaemic attack (TIA) and oral anticoagulant (OAC) adherence using Bradford Hill's criteria and to determine the factors influencing OAC adherence following ischaemic stroke in atrial fibrillation (AF) patients.
designWe conducted a scoping review. DATA SOURCES: MEDLINE, Embase and Web of Science from inception up to March 2026.
resultsThe analysis included 43 studies on OAC adherence across different phases: initiation (n=1), implementation (n=15), implementation and discontinuation (n=7) and persistence (n=20). Of these, 26 studies showed a positive association between ischaemic stroke history and OAC adherence while one showed a negative association. The evaluation of the body of evidence suggests a mixed association between ischaemic stroke and subsequent OAC adherence. While causality is not definitively established due to the observational nature of the included studies, they fulfil several of the classic Bradford Hill criteria, including temporality, consistency, biological gradient, coherence and plausibility. Factors like age, chronic obstructive pulmonary disease, cancer, heart failure, hypertension, myocardial infarction, anaemia, dementia, smoking, prior warfarin use, education level, stroke severity and recurrence were associated with decreased OAC adherence, whereas experiencing a first stroke was associated with increased adherence.
conclusionsExisting evidence shows mixed associations between ischaemic stroke and OAC adherence and causality also remains inconclusive. There are multiple factors that modify this relationship. Further observational studies using causality methods are needed to definitively confirm this relationship.
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