Evidence map›Paper›PMID 16847150›Full record

Trial reportCirculation2006

Clinical relevance of C-reactive protein during follow-up of patients with acute coronary syndromes in the Aggrastat-to-Zocor Trial.

David A Morrow, James A de Lemos, Marc S Sabatine, Stephen D Wiviott, Michael A Blazing, Amy Shui, Nader Rifai, Robert M Califf, Eugene Braunwald

2 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Circulation, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00251576. Cited by 76 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 2 pooled it
24.6field-weighted citation impact, top 1% 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.

NCT00251576 phase3completed

A Multicenter, Randomized, Controlled, Double-Blind Trial to Investigate the Clinical Efficacy and Tolerability of Early Treatment With Simvastatin 40 mg Daily for 30 Days, Followed by Simvastatin 80 mg Daily Thereafter in Tirofiban-Treated Acute Coronary Syndrome Patients Who Have Been Randomized to Receive Enoxaparin or Unfractionated Heparin in Conjunction With Aspirin

Ran1999Enrolled4,497Registered outcomes2Posted comparisons0ConditionsAcute Coronary SyndromeArmsA-Phase: tirofiban; Z-Phase simvastatin, Comparator: A-Phase: low molecular weight heparin, unfractionated heparin, Duration of Treatment: A-Phase: low molecular weight heparin, 2 to 8 days; unfractionated heparin, minium suggested 48 hours, maximum 108 hours, Duration of Treatment: A-Phase: minimum suggested 48 hours, maximum suggested 108 hours. Z-Phase: 2 years, Duration of Treatment: Z-Phase, 2 years.
PMID 16534008PMID 16352794PMID 15337732PMID 16950174PMID 15451146other papers from this trial
Open the trial in the graph
NCT03516903 phase2 / phase3terminatednot on this mapstarted 2018, after this paper: background citation

Effect of Methotrexate Carried by a Lipid Nanoemulsion on Left Ventricular Remodeling After ST-elevation Myocardial Infarction

TypeinterventionalSponsorUniversity of Sao PauloRan2018 to 2020Enrolled35ConditionsMyocardial Infarction, Anterior Wall, Myocardial Remodeling, VentricularArmsMethotrexate, Placebo, Folic Acid
3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 2 syntheses or guidelines pooled it, 311 citations in OpenAlex.

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  11. Benefit of intensive statin therapy in women: results from PROVE IT-TIMI 22.Circulation. Cardiovascular quality and outcomes · 2011
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16 more citing papers are in PubMed but not listed here.

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

9 authors at 2 institutions in 1 country.

David A MorrowTIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, Massachusetts 02115, USA. dmorrow@partners.org
James A de Lemos
Marc S Sabatine
Stephen D Wiviott
Michael A Blazing
Amy Shui
Nader Rifai
Robert M Califf
Eugene Braunwald
Clinical Research Institute · USThe University of Texas Southwestern Medical Center · US

Funding

ACTIN CAPPING PROTEINS IN PLATELETS AND MUSCLEK08HL001341 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI CASELLA, JAMES F · 1985 to 1988
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NHLBI NIH HHS U01 HL083-1341
6 · The paper itself

Abstract

backgroundElevated levels of high-sensitivity C-reactive protein (hsCRP) are associated with higher risk of adverse outcomes in patients at risk for or with established coronary artery disease. Retrospective analyses suggest that this risk may be modified with statin therapy. However, a role for hsCRP in monitoring the success of therapy remains uncertain. METHODS AND

resultsWe measured the serum concentration of hsCRP at 30 days (n=3813) and 4 months in patients with non-ST-elevation or ST-elevation acute coronary syndrome randomly assigned to an early intensive versus delayed conservative simvastatin strategy in the Aggrastat-to-Zocor Trial. Patients with hsCRP >3 mg/L at 30 days had significantly higher 2-year mortality rates than those with hsCRP 1 to 3 mg/L or hsCRP <1 mg/L (6.1% versus 3.7% versus 1.6%, P<0.0001). Results were similar with hsCRP measured at 4 months. After adjusting for age, gender, diabetes, smoking, cardiovascular history, index event, lipid levels, and randomly assigned treatment, patients with hsCRP >3 mg/L were at more than 3-fold higher risk of death (HR, 3.7; 95% CI, 1.9 to 7.2) compared with those with hsCRP <1 mg/L. "Average" levels of hsCRP (1 to 3 mg/L) were also associated with increased risk compared with those with hsCRP <1 mg/L (HR, 2.3; 95% CI, 1.2 to 4.6). Patients allocated to early intensive statin therapy were more likely to achieve hsCRP levels <1 mg/L at 30 days (P=0.028) and 4 months (P<0.0001).

conclusionsAchieved levels of hsCRP at 30 days and 4 months after acute coronary syndrome are independently associated with long-term survival. Patients treated with more aggressive statin therapy are more likely to achieve lower levels of hsCRP.

Indexed as

Acute DiseaseAgedCoronary DiseaseC-Reactive ProteinFemaleFollow-Up StudiesHumansLipoproteins, LDLMaleMiddle AgedPrognosisRisk FactorsSimvastatinSurvival AnalysisTirofibanTyrosineC-Reactive ProteinLipoproteins, LDLSimvastatinTirofibanTyrosine

Identifiers

PMID16847150
OpenAlexW2119475547

What OpenQuestion holds

Textmetadata
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.