Evidence map›Paper›PMID 41378491›Full record

Observational studyJournal of the American Heart Association2025

Association of Subgingival Microbiota Composition With Risk, Severity, and Outcome of Cryptogenic Ischemic Stroke in Young Adults.

Muhammed Manzoor, Svetislav Zaric, Anbo Dong, Jaakko Leskelä, Milla Pietiäinen, Eija Könönen, Pauli Ylikotila, Christian Enzinger, Stefan Ropele, Thomas Gattringer and 5 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01934725 (Searching for Explanations for Cryptogenic Stroke in the Young), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT01934725 active not recruitingnot on this map

Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO)

TypeobservationalSponsorSECRETO Study ConsortiumRan2013 to 2031Enrolled1,200ConditionsBrain Infarction, Ischemic Stroke, Thrombosis, Foramen Ovale, Patent
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Human Oral-AssociatedMicroorganisms · 2026
    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

15 authors.

Muhammed ManzoorDepartment of Oral and Maxillofacial Diseases University of Helsinki Finland.ORCID 0000-0002-7939-1563
Svetislav ZaricCentre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences King's College London London United Kingdom.ORCID 0000-0003-4127-0253
Anbo DongCentre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences King's College London London United Kingdom.ORCID 0009-0003-9196-7128
Jaakko LeskeläDepartment of Oral and Maxillofacial Diseases University of Helsinki Finland.ORCID 0000-0001-9670-339X
Milla PietiäinenDepartment of Oral and Maxillofacial Diseases University of Helsinki Finland.ORCID 0000-0002-4875-0682
Eija KönönenInstitute of Dentistry University of Turku Finland.ORCID 0000-0002-1897-4263
Pauli YlikotilaDepartment of Neurology Turku University Hospital, University of Turku Finland.ORCID 0009-0002-4126-9666
Christian EnzingerDepartment of Neurology Medical University of Graz Austria.
Stefan RopeleDepartment of Neurology Medical University of Graz Austria.ORCID 0000-0002-5559-768X
Thomas GattringerDepartment of Neurology Medical University of Graz Austria.ORCID 0000-0002-6065-6576
Sebastian EppingerDepartment of Neurology Medical University of Graz Austria.
Juha SinisaloDepartment of Medicine, Division of Cardiology Helsinki University Central Hospital Helsinki Finland.ORCID 0000-0002-0169-5137
Jukka PutaalaDepartment of Neurology Helsinki University Hospital and University of Helsinki Finland.ORCID 0000-0002-6630-6104
Pirkko J PussinenDepartment of Oral and Maxillofacial Diseases University of Helsinki Finland.ORCID 0000-0003-3563-1876
Susanna PajuDepartment of Oral and Maxillofacial Diseases University of Helsinki Finland.ORCID 0000-0002-2048-3420

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOral and gut dysbiosis has been linked to stroke pathogenesis and its prognosis. However, the relationship between the subgingival microbiota and cryptogenic ischemic stroke (CIS) remains unclear. We compared the subgingival microbiota of patients with CIS and their age-and sex-matched stroke-free controls to identify the specific microbiota associated with CIS, stroke symptom severity, and clinical outcome.

methodsThis multicenter, case-control study was conducted between 2013 and 2019 as part of a screening protocol for the SECRETO (Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome) study (NCT01934725). Stroke severity was assessed using the National Institutes of Health Stroke Scale score. After thorough clinical and radiographic oral examinations, subgingival samples were collected and analyzed using 16S rRNA gene sequencing.

resultsA total of 272 participants (134 patients and 138 controls) were included. There were no differences in the following clinical characteristics between patients and controls: diabetes, hypertension, smoking, alcohol use, abdominal obesity, physical activity, and chronic multiorgan disease. Beta diversity differed significantly between patients and controls (

conclusionsThe subgingival microbiota is associated with CIS, suggesting a possible link between oral health and stroke pathophysiology. Although causality cannot be proven, oral microbiota may be a modifiable treatment target for the prevention of CIS and improving its outcome.

Indexed as

DysbiosisGingivaIschemic StrokeMicrobiotaAdultCase-Control StudiesFemaleHumansMalePrognosisRisk AssessmentRisk FactorsSeverity of Illness IndexYoung Adult16S rRNA gene sequencingmodified Rankin Scalestroke severitysubgingival microbiomeyoung‐onset stroke

Identifiers

PMID41378491
PMCPMC12826904

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.