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Record W2788275981 · doi:10.1212/wnl.0000000000005126

Atrial fibrillation detected after stroke is related to a low risk of ischemic stroke recurrence

2018· article· en· W2788275981 on OpenAlexaffabout
Luciano A. Sposato, Joshua O. Cerasuolo, Lauren E. Cipriano, Jiming Fang, Sebastián Fridman, Maryse Paquet, Gustavo Saposnik, Shawn N. Whitehead, Kurt Kimpinksi, Michael B. Boffa, Marlys L. Koschinsky, Agustín Ibáñez, Peter Leong‐Sit, James Melling, Manuel Montero‐Odasso, Marko Mrkobrada, J. Kevin Shoemaker, Kelly L. Summers, Victoria Thorburn, Victoria Jaremek, Brittany Balint, Lucy Samoilov, Devin Stirling, Ali R. Khan, Renato D. Lópes, Jennifer Mandzia, Alexander V. Khaw

Bibliographic record

VenueNeurology · 2018
Typearticle
Languageen
FieldMedicine
TopicAtrial Fibrillation Management and Outcomes
Canadian institutionsLondon Health Sciences CentreUniversity of TorontoSt. Michael's HospitalInstitute for Clinical Evaluative SciencesWestern University
Fundersnot available
KeywordsMedicineAtrial fibrillationStroke (engine)Internal medicineCardiologyHazard ratioMyocardial infarctionHeart failureSinus rhythmProportional hazards modelCohortHeart diseaseRetrospective cohort studyCerebral infarctionConfidence intervalCoronary artery diseaseIschemia

Abstract

fetched live from OpenAlex

<h3>Objective</h3> To compare the risk of 1-year ischemic stroke recurrence between atrial fibrillation (AF) diagnosed after stroke (AFDAS) and sinus rhythm (SR) and investigate whether underlying heart disease is as frequent in AFDAS as it is in AF known before stroke (KAF). <h3>Methods</h3> In this retrospective cohort study, we included all ischemic stroke patients admitted to institutions participating in the Ontario Stroke Registry from July 1, 2003, to March 31, 2013. Based on heart rhythm assessed during admission, we classified patients as AFDAS, KAF, or SR. We modeled the relationship between heart rhythm groups and 1-year ischemic stroke recurrence by using Cox regression adjusted for multiple covariates (e.g., oral anticoagulants). We compared the prevalence of coronary artery disease, myocardial infarction, and heart failure among the 3 groups. <h3>Results</h3> Among 23,376 ischemic stroke patients, 15,885 had SR, 587 AFDAS, and 6,904 KAF. At 1 year, 39 (6.6%) patients with AFDAS, 661 (9.6%) with KAF, and 1,269 (8.0%) with SR had recurrent ischemic strokes (<i>p</i> = 0.0001). AFDAS-related ischemic stroke recurrence adjusted risk was not different from that of SR (hazard ratio 0.90 [95% confidence interval 0.63, 1.30]; <i>p</i> = 0.57). Prevalence of coronary artery disease (18.2% vs 34.7%; <i>p</i> &lt; 0.0001), myocardial infarction (11.6% vs 20.5%; <i>p</i> &lt; 0.0001), and heart failure (5.5% vs 16.8%; <i>p</i> &lt; 0.0001) were lower in AFDAS relative to KAF. <h3>Conclusions</h3> The lack of difference in 1-year ischemic stroke recurrence between AFDAS and SR and the lower prevalence of heart disease in AFDAS compared to KAF suggest that the underlying pathophysiology of AFDAS may differ from that of KAF.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.118
Threshold uncertainty score0.734

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.018
GPT teacher head0.292
Teacher spread0.274 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations102
Published2018
Admission routes2
Has abstractyes

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