MétaCan
Menu
Back to cohort
Record W4411310835 · doi:10.1177/23969873251344485

Location, size, and risk factors of incident covert brain infarcts in patients with acute non-cardioembolic ischemic stroke: PACIFIC-STROKE trial

2025· article· en· W4411310835 on OpenAlexaff
Robert G. Hart, Eric E. Smith, Angela Wang, Hardi Mundl, Pablo Colorado, Raed A. Joundi, Aristeidis H. Katsanos, Mukul Sharma, Ashkan Shoamanesh

Bibliographic record

VenueEuropean Stroke Journal · 2025
Typearticle
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsUniversity of CalgaryMcMaster UniversityPopulation Health Research Institute
FundersBayer
KeywordsStroke (engine)MedicineCovertCardiologyInternal medicineIschemic strokeBrain infarctionIschemia

Abstract

fetched live from OpenAlex

INTRODUCTION: Covert brain infarcts (CBIs) identified by imaging are more frequent than symptomatic ischemic strokes and are usually small and/or involve non-eloquent brain areas. The spectrum of incident CBIs in patients following acute ischemic stroke has not been well characterized. PATIENTS AND METHODS: Exploratory observational cohort study of the size, location, multiplicity and risk factors of incident CBIs identified using serial MRIs in patients with acute non-cardioembolic ischemic stroke participating in the PACIFIC-STROKE trial. RESULTS: Incident CBIs were identified in 16% (220/1358) of participants during the mean 5.6-month interval between MRIs. Single incident CBIs occurred in 150 (68%) of incident CBI patients and multiple CBIs in 70 (32%); 42% (93/220) of incident CBI patients had a single, small, subcortical CBI. There was no clear relationship between the location of incident CBI and the location of index stroke. Significant independent features associated with incident CBI included diabetes (adjusted OR 1.52, 95%CI 1.09-2.12), current tobacco use (adjusted OR 1.50, 95%CI 1.07-2.09), prior stroke/TIA (adjusted OR 1.59, 95%CI 1.08-2.36), carotid artery atherosclerosis (adjusted OR 1.47, 95%CI 1.07-2.02), and diastolic blood pressure (adjusted OR 1.02 per 1 mmHg increase, 95%CI 1.01-1.04). DISCUSSION AND CONCLUSION: Incident CBIs in patients following acute non-cardioembolic stroke were frequent, usually small and subcortical, and associated with traditional stroke risk factors. Observations from PACIFIC-STROKE, particularly the absence of correlation between the location of incident CBI and the index infarct and the high frequency of incident small, subcortical CBIs, suggest that incident CBI pathogenesis is complex and heterogeneous in this population. TRIAL REGISTRATION: https://clinicaltrials.gov (NCT04304508).

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)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.046
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

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 head0.005
GPT teacher head0.226
Teacher spread0.221 · 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.

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

Citations0
Published2025
Admission routes1
Has abstractyes

Explore more

Same venueEuropean Stroke JournalSame topicAcute Ischemic Stroke ManagementFrench-language works237,207