Evidence map›Paper›PMID 34879833›Full record

ArticleBMC neurology2021

Neopterin and kynurenic acid as predictors of stroke recurrence and mortality: a multicentre prospective cohort study on biomarkers of inflammation measured three months after ischemic stroke.

Katinka Nordheim Alme, Arve Ulvik, Torunn Askim, Jörg Assmus, Tom Eirik Mollnes, Mala Naik, Halvor Næss, Ingvild Saltvedt, Per-Magne Ueland, Anne-Brita Knapskog

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

Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02650531 (Norwegian COgnitive Impairment After STroke), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 43% 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.

NCT02650531 completednot on this map

Norwegian COgnitive Impairment After STroke (NorCOAST) Study

TypeobservationalSponsorNorwegian University of Science and TechnologyRan2015 to 2018Enrolled816ConditionsDementia, Mild Cognitive Impairment, Stroke
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Review
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

10 authors at 7 institutions in 1 country.

Katinka Nordheim AlmeInstitute of Clinical Medicine (K1), University of Bergen, Bergen, Norway. Katinka.alme@gmail.com.
Arve UlvikBevital AS, Bergen, Norway.
Torunn AskimDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
Jörg AssmusCentre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
Tom Eirik MollnesDepartment of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway.
Mala NaikDepartment of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway.
Halvor NæssInstitute of Clinical Medicine (K1), University of Bergen, Bergen, Norway.
Ingvild SaltvedtDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
Per-Magne UelandBevital AS, Bergen, Norway.
Anne-Brita KnapskogDepartment of Geriatric Medicine, Oslo University Hospital. Ullevaal, Oslo, Norway.
Bevital (Norway) · NONorwegian University of Science and Technology · NOUniversity of Bergen · NOHaukeland University Hospital · NOOslo University Hospital · NOStavanger University Hospital · NOUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic low-grade inflammation is associated with both ischemic stroke and sedentary behaviour. The aim of this study was to investigate the predictive abilities of biomarkers of inflammation and immune modulation associated with sedentary behaviour for ischemic stroke recurrence and mortality in a stroke population.

methodsPatients admitted to hospital for acute stroke were recruited to the prospective multicentre cohort study, the Norwegian Cognitive Impairment After Stroke (Nor-COAST) study, from May 2015 until March 2017. Patients with ischemic stroke, blood samples available from the three-month follow-up, and no stroke recurrence before the three-month follow-up were included. Serum was analysed for C-reactive protein (CRP) with high-sensitive technique, and plasma for interleukin-6 (IL-6), neopterin, pyridoxic acid ratio index (PAr-index: 4-pyridoxic acid: [pyrioxal+pyridoxal-5'-phosphate]) and kynurenic acid (KA). Ischemic stroke recurrence and death were identified by the Norwegian Stroke Registry and the Cause of Death Registry until 31 December 2018.

resultsThe study included 354 patients, 57% male, mean age 73 (SD 11) years, mean observation time 2.5 (SD 0.6) years, and median National Institute of Health Stroke Scale of 0 (IQR 1) at three months. CRP was associated with mortality (HR 1.40, CI 1.01, 1.96, p = 0.046), and neopterin was associated with the combined endpoint (recurrent ischemic stroke or death) (HR 1.52, CI 1.06, 2.20, p = 0.023), adjusted for age, sex, prior cerebrovascular disease, modified Rankin Scale, and creatinine. When adding neopterin and KA to the same model, KA was negatively associated (HR 0.57, CI 0.33, 0.97, p = 0.038), and neopterin was positively associated (HR 1.61, CI 1.02, 2.54, p = 0.040) with mortality. Patients with cardioembolic stroke at baseline had higher levels of inflammation at three months.

conclusionNeopterin might be a valuable prognostic biomarker in stroke patients. The use of KA as a measure of anti-inflammatory capacity should be investigated further.

trial registrationThe study was registered at Clinicaltrials.gov ( NCT02650531 ). First posted on 08/01/2016.

Indexed as

Brain IschemiaIschemic StrokeStrokeAgedBiomarkersCohort StudiesFemaleHumansInflammationKynurenic AcidMaleNeopterinProspective StudiesBiomarkersKynurenic AcidNeopterinImmune modulationInflammationKynurenine pathwaySedentary behaviourStrokeVascular disease

Identifiers

PMID34879833
PMCPMC8653541
OpenAlexW4200219059

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.