Evidence map›Paper›PMID 26696648›Full record

ArticleStroke2016

Association of Exhaled Carbon Monoxide With Stroke Incidence and Subclinical Vascular Brain Injury: Framingham Heart Study.

Matthew Nayor, Danielle M Enserro, Alexa S Beiser, Susan Cheng, Charles DeCarli, Ramachandran S Vasan, Sudha Seshadri

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 33% 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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
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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

7 authors at 3 institutions in 1 country.

Matthew NayorFrom the Framingham Heart Study, MA (M.N., A.S.B., S.C., R.S.V., S.S.); Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.N., S.C.); Departments of Biostatistics (D.M.E., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (A.S.B., S.S) and Sections of Preventive Medicine & Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA; and Department of Neurology and Center for Neuroscience, University of California at Davis (C.D.).
Danielle M EnserroFrom the Framingham Heart Study, MA (M.N., A.S.B., S.C., R.S.V., S.S.); Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.N., S.C.); Departments of Biostatistics (D.M.E., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (A.S.B., S.S) and Sections of Preventive Medicine & Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA; and Department of Neurology and Center for Neuroscience, University of California at Davis (C.D.).
Alexa S BeiserFrom the Framingham Heart Study, MA (M.N., A.S.B., S.C., R.S.V., S.S.); Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.N., S.C.); Departments of Biostatistics (D.M.E., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (A.S.B., S.S) and Sections of Preventive Medicine & Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA; and Department of Neurology and Center for Neuroscience, University of California at Davis (C.D.).
Susan ChengFrom the Framingham Heart Study, MA (M.N., A.S.B., S.C., R.S.V., S.S.); Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.N., S.C.); Departments of Biostatistics (D.M.E., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (A.S.B., S.S) and Sections of Preventive Medicine & Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA; and Department of Neurology and Center for Neuroscience, University of California at Davis (C.D.).
Charles DeCarliFrom the Framingham Heart Study, MA (M.N., A.S.B., S.C., R.S.V., S.S.); Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.N., S.C.); Departments of Biostatistics (D.M.E., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (A.S.B., S.S) and Sections of Preventive Medicine & Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA; and Department of Neurology and Center for Neuroscience, University of California at Davis (C.D.).
Ramachandran S VasanFrom the Framingham Heart Study, MA (M.N., A.S.B., S.C., R.S.V., S.S.); Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.N., S.C.); Departments of Biostatistics (D.M.E., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (A.S.B., S.S) and Sections of Preventive Medicine & Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA; and Department of Neurology and Center for Neuroscience, University of California at Davis (C.D.).
Sudha SeshadriFrom the Framingham Heart Study, MA (M.N., A.S.B., S.C., R.S.V., S.S.); Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.N., S.C.); Departments of Biostatistics (D.M.E., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (A.S.B., S.S) and Sections of Preventive Medicine & Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA; and Department of Neurology and Center for Neuroscience, University of California at Davis (C.D.).
Boston University · USBrigham and Women's Hospital · USFramingham Heart Study · US

Funding

UC Davis Alzheimer's Disease Core CenterP30AG010129 · NIA · UNIVERSITY OF CALIFORNIA DAVIS · PI DECARLI, CHARLES · 1991 to 2020
$28.3M
PRECURSORS OF STROKE INCIDENCE AND PROGNOSISR01NS017950 · NINDS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI Hugo Javier Aparicio, Jose Rafael Romero · 1985 to 2026
$22.9M
TRAINING PROGRAM IN CARDIOVASCULAR RESEARCHT32HL007604 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MARK W FEINBERG · 1985 to 2026
$19.0M
EPIDEMIOLOGY OF DEMENTIA IN THE FRAMINGHAM STUDYR01AG008122 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI AU, RHODA, SESHADRI, SUDHA · 1989 to 2015
$14.4M
Temporal Trends, Novel Imaging and Molecular Characterization of Preclinical and Clinical Alzheimer's Disease in the Framingham CohortsR01AG054076 · NIA · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI DECARLI, CHARLES, SESHADRI, SUDHA · 2016 to 2020
$12.3M
Harvard Regional Clinical Center of the NHLBI Heart Failure NetworkU10HL110337 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI GIVERTZ, MICHAEL M, LEWIS, GREGORY DYER · 2012 to 2018
$3.5M
Myocardial and Arterial Aging: Spectrum, Correlates, and PrognosisR00HL107642 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI CHENG, SUSAN · 2014 to 2016
$747k
THE FRAMINGHAM HEART STUDY-N01HC25195-268025195-268025195N01HC025195 · HC · TRUSTEES OF BOSTON UNIVERSITY · PI WOLF, PHILIP A · 2002 to 2006
–
NHLBI NIH HHS N01 HC025195NHLBI NIH HHS N01-HC-25195NHLBI NIH HHS R00 HL107642NHLBI NIH HHS T32 HL007604NHLBI NIH HHS T32-HL007604NHLBI NIH HHS U10 HL110337NHLBI NIH HHS U10HL110337NIA NIH HHS P30 AG010129NIA NIH HHS P-30-AG10129NIA NIH HHS R01 AG008122NIA NIH HHS R01 AG054076NIA NIH HHS R01-AG-08122NINDS NIH HHS R01 NS017950NINDS NIH HHS R01-NS-17950
6 · The paper itself

Abstract

background and purposeExhaled carbon monoxide (CO) is associated with cardiometabolic traits, subclinical atherosclerosis, and cardiovascular disease, but its specific relations with stroke are unexplored. We related exhaled CO to magnetic resonance imaging measures of subclinical cerebrovascular disease cross-sectionally and to incident stroke/transient ischemic attack prospectively in the Framingham Offspring study.

methodsWe measured exhaled CO in 3313 participants (age 59±10 years; 53% women), and brain magnetic resonance imaging was available in 1982 individuals (age 58±10 years; 54% women). Participants were analyzed according to tertiles of exhaled CO concentration.

resultsIn age- and sex-adjusted models, the highest tertile of exhaled CO was associated with lower total cerebral brain volumes, higher white-matter hyperintensity volumes, and greater prevalence of silent cerebral infarcts (P<0.05 for all). The results for total cerebral brain volume and white-matter hyperintensity volume were consistent after removing smokers from the sample, and the association with white-matter hyperintensity volume persisted after multivariable adjustment (P=0.04). In prospective analyses (mean follow-up 12.9 years), higher exhaled CO was associated with 67% (second tertile) and 97% (top tertile) increased incidence of stroke/transient ischemic attack relative to the first tertile that served as referent (P<0.01 for both). These results were consistent in nonsmokers and were partially attenuated upon adjustment for vascular risk factors.

conclusionsIn this large, community-based sample of individuals without clinical stroke/transient ischemic attack at baseline, higher exhaled CO was associated with a greater burden of subclinical cerebrovascular disease cross-sectionally and with increased risk of stroke/transient ischemic attack prospectively. Further investigation is necessary to explore the biological mechanisms linking elevated CO with stroke.

Indexed as

Asymptomatic DiseasesAgedAtherosclerosisBrainBreath TestsCarbon MonoxideCerebral InfarctionCerebrovascular DisordersCohort StudiesCross-Sectional StudiesFemaleHumansIschemic Attack, TransientMagnetic Resonance ImagingMaleMiddle AgedCarbon Monoxidebiomarkerscarbon monoxideheme oxygenase (decyclizing)ischemic attack, transientstroke

Identifiers

PMID26696648
PMCPMC4729607
OpenAlexW2260007965

What OpenQuestion holds

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Read underepoch 390

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 OpenQuestion graph.