Evidence map›Paper›PMID 38287505›Full record

ArticleAnnals of clinical and translational neurology2024

First-ever acute ischemic strokes in HIV-infected persons: A case-control study from stroke units.

Romain Stammler, Jessica Guillaume, Mikael Mazighi, Christian Denier, Igor Raynouard, Bertrand Lapergue, Thomas De Broucker, Elena Meseguer, Hassan Hosseini, Anne Leger and 4 more

Open access · goldAbstract read
In one paragraph

Article in Annals of clinical and translational neurology, 2024. 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
0.7field-weighted citation impact, top 34% of its field
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 citations in OpenAlex.

  1. Review
  2. 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

14 authors at 9 institutions in 1 country.

Romain StammlerDepartment of Neurology and Stroke Unit, Rothschild Foundation Hospital, Paris, France.
Jessica GuillaumeClinical Research Unit, Rothschild Foundation Hospital, Paris, France.
Mikael MazighiAPHP, Department of Neurology and Stroke Unit, Lariboisière Hospital, and Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France.
Christian DenierAPHP, Department of Neurology and Stroke Unit, Hôpital Bicêtre, Paris Saclay University, Le Kremlin-Bicêtre, France.
Igor RaynouardDepartment of Neurology and Stroke Unit, Rothschild Foundation Hospital, Paris, France.
Bertrand LapergueDepartment of Neurology and Stroke Unit, Foch Hospital, Versailles Saint-Quentin-en-Yvelines University, Suresnes, France.
Thomas De BrouckerDepartment of Neurology and Stroke Unit, Delafontaine Hospital, Saint-Denis, France.
Elena MeseguerAPHP, Department of Neurology and Stroke Unit, Bichat-Claude-Bernard Hospital, INSERM LVTS-U1148, DHU FIRE, University of Paris, Paris, France.
Hassan HosseiniAPHP, Department of Neurology and Stroke Unit, Henri-Mondor Hospital, University of Paris XII, Créteil, France.
Anne LegerAPHP, Stroke Unit, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.
Didier SmadjaDepartment of Neurology and Stroke Unit, Centre Hospitalier Sud-Francilien, Paris Saclay University, Corbeil-Essonnes, France.
Catherine LamyNeurology Department and Stroke Unit, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France.
Michael ObadiaDepartment of Neurology and Stroke Unit, Rothschild Foundation Hospital, Paris, France.
Antoine MoulignierDepartment of Neurology and Stroke Unit, Rothschild Foundation Hospital, Paris, France.ORCID 0000-0001-7566-0175
Fondation de Rothschild · FRUniversité Paris-Saclay · FRAssistance Publique – Hôpitaux de Paris · FRCentre Hospitalier Saint-Denis · FRCentre Hospitalier Sainte-Anne · FRInserm · FRSorbonne Université · FRUniversité de Versailles Saint-Quentin-en-Yvelines · FRUniversité Paris-Est Créteil · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe stroke risk for persons living with human immunodeficiency virus (PLHIVs) doubled compared to uninfected individuals. Stroke-unit (SU)-access, acute reperfusion therapy-use and outcome data on PLHIVs admitted for acute ischemic stroke (AIS) are scarce.

methodsAIS patients admitted (01 January 2017 to 31 January 2021) to 10 representative Paris-area SUs were screened retrospectively from the National Hospitalization Database. PLHIVs were compared to age-, initial NIHSS- and sex-matched HIV-uninfected controls (HUCs). Outcome was the 90-day modified Rankin Scale score.

resultsAmong 126 PLHIVs with confirmed first-ever AIS, ~80% were admitted outside the thrombolysis-administration window. Despite antiretrovirals, uncontrolled plasma HIV loads exceeded 50 copies/mL (26% of all PLHIVs; 38% of those ≤55 years). PLHIVs' stroke causes by decreasing frequency were large artery atherosclerosis (LAA), undetermined, other cause, cerebral small-vessel disease (CSVD) or cardioembolism. No stroke etiology was associated with HIV duration or detectable HIVemia. MRI revealed previously unknown AIS in one in three PLHIVs, twice the HUC rate (p = 0.006). Neither group had optimally controlled modifiable cardiovascular risk factors (CVRFs): 20%-30% without specific hypertension, diabetes, and/or dyslipidemia treatments. Their stroke outcomes were comparable. Multivariable analyses retained good prognosis associated solely with initial NIHSS or reperfusion therapy. Older age and hypertension were associated with CSVD/LAA for all PLHIVs. Standard neurovascular care and reperfusion therapy were well-tolerated.

interpretationThe high uncontrolled HIV-infection rate and suboptimal CVRF treatment support heightened vigilance to counter suboptimal HIV suppression and antiretroviral adherence, and improve CVRF prevention, mainly for younger PLHIVs. Those preventive, routine measures could lower PLHIVs' AIS risk.

Indexed as

Brain IschemiaHIV InfectionsHypertensionIschemic StrokeStrokeCase-Control StudiesHIVHumansRetrospective StudiesTreatment Outcome

Identifiers

PMID38287505
PMCPMC11021677
OpenAlexW4391359689

What Socratic holds

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LicenceCC BY-NC-ND
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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 Socratic graph.