Evidence map›Paper›PMID 26888535›Full record

Observational studyStroke2016

Inflammatory Markers and Outcomes After Lacunar Stroke: Levels of Inflammatory Markers in Treatment of Stroke Study.

Amelia K Boehme, Leslie A McClure, Yu Zhang, Jorge M Luna, Oscar H Del Brutto, Oscar R Benavente, Mitchell S V Elkind

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00059306 (Secondary Prevention of Small Subcortical Strokes), which is not on this map. Cited by 52 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 4 pooled it
6.2field-weighted citation impact, top 3% 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.

NCT00059306 phase3completednot on this map

Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

TypeinterventionalSponsorUniversity of British ColumbiaRan2003 to 2012Enrolled3,020ConditionsCerebrovascular Accident, HypertensionArmsaspirin, clopidogrel, Target of Blood Pressure, placebo
3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 4 syntheses or guidelines pooled it, 101 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
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  12. Article
  13. Targeting inflammation to reduce recurrent stroke.International journal of stroke : official journal of the International Stroke Society · 2024
    Review
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Updates of the role of B-cells in ischemic stroke.Frontiers in cellular neuroscience · 2024
    Review
  20. 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

7 authors at 2 institutions in 2 countries.

Amelia K BoehmeFrom the Department of Neurology, College of Physicians and Surgeons (A.K.B., J.M.L., M.S.V.E.) and Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.), Columbia University, New York; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (Y.Z.); Department of Neurological Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.); and Department of Neurology, University of British Columbia, Vancouver, Canada (O.R.B.). akb2188@cumc.columbia.edu.
Leslie A McClureFrom the Department of Neurology, College of Physicians and Surgeons (A.K.B., J.M.L., M.S.V.E.) and Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.), Columbia University, New York; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (Y.Z.); Department of Neurological Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.); and Department of Neurology, University of British Columbia, Vancouver, Canada (O.R.B.).
Yu ZhangFrom the Department of Neurology, College of Physicians and Surgeons (A.K.B., J.M.L., M.S.V.E.) and Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.), Columbia University, New York; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (Y.Z.); Department of Neurological Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.); and Department of Neurology, University of British Columbia, Vancouver, Canada (O.R.B.).
Jorge M LunaFrom the Department of Neurology, College of Physicians and Surgeons (A.K.B., J.M.L., M.S.V.E.) and Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.), Columbia University, New York; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (Y.Z.); Department of Neurological Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.); and Department of Neurology, University of British Columbia, Vancouver, Canada (O.R.B.).
Oscar H Del BruttoFrom the Department of Neurology, College of Physicians and Surgeons (A.K.B., J.M.L., M.S.V.E.) and Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.), Columbia University, New York; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (Y.Z.); Department of Neurological Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.); and Department of Neurology, University of British Columbia, Vancouver, Canada (O.R.B.).
Oscar R BenaventeFrom the Department of Neurology, College of Physicians and Surgeons (A.K.B., J.M.L., M.S.V.E.) and Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.), Columbia University, New York; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (Y.Z.); Department of Neurological Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.); and Department of Neurology, University of British Columbia, Vancouver, Canada (O.R.B.).
Mitchell S V ElkindFrom the Department of Neurology, College of Physicians and Surgeons (A.K.B., J.M.L., M.S.V.E.) and Department of Epidemiology, Mailman School of Public Health (A.K.B., M.S.V.E.), Columbia University, New York; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (L.A.M.); Department of Biostatistics, School of Public Health, University of Alabama at Birmingham (Y.Z.); Department of Neurological Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador (O.H.D.B.); and Department of Neurology, University of British Columbia, Vancouver, Canada (O.R.B.).
Drexel University · USUniversity of British Columbia · CA

Funding

SECONDARY PREVENTION OF SMALL SUBCORTICAL STROKES (SPSS)U01NS038529 · NINDS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI BENAVENTE, OSCAR R · 2003 to 2012
$62.9M
NEUROEPIDEMIOLOGY TRAINING PROGRAMT32NS007153 · NINDS · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI GU, YIAN, WILLEY, JOSHUA ZEBADIAH · 1987 to 2023
$6.2M
Levels of Inflammatory Markers in Treatment of StrokeR01NS050724 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ELKIND, MITCHELL S · 2005 to 2008
$1.2M
NINDS NIH HHS R01 NS050724NINDS NIH HHS T32 NS007153NINDS NIH HHS U01 NS038529
6 · The paper itself

Abstract

background and purposeWe hypothesized that concentrations of interleukin 6 (IL-6), serum amyloid A, tumor necrosis factor-α receptor 1, CD40 ligand, and monocyte chemoattractant protein 1 would predict recurrent ischemic stroke and major vascular events after recent lacunar stroke.

methodsLevels of Inflammatory Markers in the Treatment of Stroke (LIMITS) was an international, multicenter, prospective ancillary biomarker study nested within the Secondary Prevention of Small Subcortical Strokes (SPS3) study, a Phase III trial in patients with recent lacunar stroke. Crude and Adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CI) for recurrence risks.

resultsAmong 1244 patients with lacunar stroke (mean age, 63.3±10.8 years), there were 115 major vascular events (stroke, myocardial infarction, and vascular death). The risk of major vascular events increased with elevated concentrations of both tumor necrosis factor-α receptor 1 (adjusted HR per SD, 1.21; 95% CI, 1.05-1.41; P=0.01) and IL-6 (adjusted HR per SD, 1.10; 95% CI, 1.02-1.19; P=0.008). Compared with the bottom quartile (tumor necrosis factor-α receptor 1 <2.24 ng/L), those in the top quartile of tumor necrosis factor-α receptor 1 (>3.63 ng/L) were at twice the risk of major vascular events after adjusting for demographics (partially adjusted HR, 1.98; 95% CI, 1.11-3.52), though the effect attenuated after adjusting for other risk factors and statin use (adjusted HR, 1.68; 95% CI, 0.93-3.04). Serum amyloid A, CD40 ligand, and monocyte chemoattractant protein 1 were not associated with prognosis.

conclusionsAmong recent lacunar stroke patients, IL-6 and TNF receptor concentrations predict risk of recurrent vascular events, and they are associated with the effect of antiplatelet therapies. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00059306.

Indexed as

Inflammation MediatorsInterleukin-6Receptors, Tumor Necrosis Factor, Type IStroke, LacunarAgedBiomarkersClinical Trials, Phase III as TopicFemaleHumansMaleMiddle AgedPlatelet Aggregation InhibitorsProspective StudiesRisk FactorsTreatment OutcomeBiomarkersIL6 protein, humanInflammation MediatorsInterleukin-6Platelet Aggregation InhibitorsReceptors, Tumor Necrosis Factor, Type Iinflammationinterleukin 6lacunar strokeprognosisstroke

Identifiers

PMID26888535
PMCPMC4766076
OpenAlexW2274048566

What OpenQuestion holds

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Registered trials

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.