Evidence map›Paper›PMID 34896817›Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2022

Plasma Pro-Enkephalin A and Ischemic Stroke Risk: The Reasons for Geographic and Racial Differences in Stroke Cohort.

Samuel Ap Short, Katherine Wilkinson, D Leann Long, Suzanne Judd, Janin Schulte, Brett M Kissela, George Howard, Mary Cushman

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

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2022. 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
0.3field-weighted citation impact, top 39% 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, 3 citations in OpenAlex.

  1. Article
  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

8 authors at 3 institutions in 1 country.

Samuel Ap ShortLarner College of Medicine, University of Vermont, Burlington, VT.
Katherine WilkinsonDepartment of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
D Leann LongDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
Suzanne JuddDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
Janin SchulteSphingoTec GmbH, Hennigsdorf, Germany.
Brett M KisselaDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.
George HowardDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
Mary CushmanDepartment of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT; Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT. Electronic address: Mary.Cushman@uvm.edu.
University of Alabama at Birmingham · USUniversity of Vermont · USUniversity of Cincinnati Medical Center · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
Vermont Center for Cardiovascular and Brain HealthP20GM135007 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI Kathryn H Morelli · 2020 to 2026
$17.4M
NIGMS NIH HHS P20 GM135007NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

objectivesThe opioid neuropeptide pro-enkephalin A (PENK-A) may be a circulating marker of cardiovascular risk, with prior findings relevant to heart failure, kidney disease, and vascular dementia. Despite these findings, the association of PENK-A with ischemic stroke is unknown, so we examined this association in a prospective cohort study and analyzed differences by race and sex. MATERIALS AND

methodsThe REasons for Geographic and Racial Differences in Stroke study (REGARDS) is a prospective cohort study of 30,239 Black and White adults. Plasma PENK-A was measured in 473 participants that developed first-time ischemic stroke over 5.9 years and 899 randomly selected participants. Cox models adjusted for demographics and stroke risk factors were used to calculate hazard ratios (HRs) of stroke by baseline PENK-A.

resultsPENK-A was higher with increasing age, female sex, White race, lower body mass index, and antihypertensive medication use. Each SD higher increment of PENK-A was associated with an adjusted HR of 1.20 (95% CI 1.01-1.42) for stroke, with minimal confounding by stroke risk factors. Spline plots suggested a U-shaped relationship, particularly in White men, with an adjusted HR 3.88 (95% CI 1.94-7.77) for the 95

conclusionsHigher baseline plasma PENK-A was independently associated with future stroke risk in REGARDS. This association was most apparent among White men. There was little confounding by established stroke risk factors, suggesting a possible causal role in stroke etiology. Further research is needed to understand the role of endogenous opioids in stroke pathogenesis.

Indexed as

EnkephalinsHealth Status DisparitiesIschemic StrokeProtein PrecursorsAdultBiomarkersBlack PeopleFemaleGeographyHumansMaleProspective StudiesRace FactorsRisk FactorsWhite PeopleBiomarkersEnkephalinsproenkephalinProtein PrecursorsCohortEpidemiologyPro-enkephalinREGARDSRisk factorsStroke risk

Identifiers

PMID34896817
PMCPMC8792292
OpenAlexW4200125059

What OpenQuestion holds

Textmetadata
LicenceTDM
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.