The PDE1 inhibitor, vinpocetine, improved clinical outcomes and reduced lesion size in acute ischaemic stroke through inhibition of NF-κB-dependent inflammation.130 This agent, however, is a weak PDE1 inhibitor and also blocks sodium channels and regulates NF-κB signalling.131 The novel and potent PDE1 inhibitor, ITI-214, was recently tested in patients with HFrEF (NCT03387215). The gene discussed is NFKB1; the disease is ischemic stroke.