{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:12:45Z","timestamp":1784563965678,"version":"3.55.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":834,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000801","name":"Bayer HealthCare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000801","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Neurology Research Pool of the University Hospital Basel"},{"name":"Science Funds Rehabilitation Felix-Platter-Hospital Basel"},{"name":"Basel Stroke Funds"},{"DOI":"10.13039\/501100004362","name":"Schweizerische Herzstiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000801","name":"Bayer HealthCare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000801","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Neurology Research Pool of the University Hospital Basel"},{"name":"Science Funds Rehabilitation Felix-Platter-Hospital Basel"},{"name":"Basel Stroke Funds"},{"DOI":"10.13039\/501100004362","name":"Schweizerische Herzstiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004362","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Data on the impact of competing stroke etiologies in stroke patients with atrial fibrillation (AF) are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used prospectively obtained data from an observational registry (Novel-Oral-Anticoagulants-in-Ischemic-Stroke-Patients-(NOACISP)-LONGTERM) of consecutive AF-stroke patients treated with oral anticoagulants. We compared the frequency of (i) the composite outcome of recurrent ischemic stroke (IS), intracerebral hemorrhage (ICH) or all-cause death as well as (ii) recurrent IS alone among AF-stroke patients with versus without competing stroke etiologies according to the TOAST classification. We performed cox proportional hazards regression modeling adjusted for potential confounders. Furthermore, the etiology of recurrent IS was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 907 patients (median age 81, 45.6% female), 184 patients (20.3%) had competing etiologies, while 723 (79.7%) had cardioembolism as the only plausible etiology. During 1587 patient-years of follow-up, patients with additional large-artery atherosclerosis had higher rates of the composite outcome (adjusted HR [95% CI] 1.64 [1.11, 2.40], p\u2009=\u20090.017) and recurrent IS (aHR 2.96 [1.65, 5.35 ], p\u2009&amp;lt;\u20090.001), compared to patients with cardioembolism as the only plausible etiology. Overall 71 patients had recurrent IS (7.8%) of whom 26.7% had a different etiology than the index IS with large-artery-atherosclerosis (19.7%) being the most common non-cardioembolic cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In stroke patients with AF, causes other than cardioembolism as competing etiologies were common in index or recurrent IS. Concomitant presence of large-artery-atherosclerosis seems to indicate an increased risk for recurrences suggesting that stroke preventive means might be more effective if they also address competing stroke etiologies in AF-stroke patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>NCT 03826927<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873231185220","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T04:21:20Z","timestamp":1688444480000},"page":"703-711","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["The impact of competing stroke etiologies in patients with atrial fibrillation"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4362-2497","authenticated-orcid":false,"given":"Annaelle","family":"Zietz","sequence":"first","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"},{"name":"Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Switzerland 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-2208","authenticated-orcid":false,"given":"Alexandros A","family":"Polymeris","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Helfenstein","sequence":"additional","affiliation":[{"name":"Clinical Trial Unit, Bern University, Bern, Switzerland 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Schaedelin","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University Hospital Basel and University of Basel, Switzerland 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Hert","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"},{"name":"Department of Intensive Care Medicine, University Hospital Basel, Switzerland 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9330-1790","authenticated-orcid":false,"given":"Benjamin","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3890-3849","authenticated-orcid":false,"given":"David J","family":"Seiffge","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, Inselspital, Bern, Switzerland 6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Traenka","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"},{"name":"Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Switzerland 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerian L","family":"Altersberger","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"},{"name":"Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Switzerland 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9987-3631","authenticated-orcid":false,"given":"Tolga","family":"Dittrich","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"},{"name":"Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland 7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefin","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland 1"},{"name":"Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Switzerland 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