Evidence map›Paper›PMID 20031199›Full record

SynthesisLancet (London, England)2010

C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis.

Emerging Risk Factors Collaboration, Stephen Kaptoge, Emanuele Di Angelantonio, Gordon Lowe, Mark B Pepys, Simon G Thompson, Rory Collins, John Danesh

2 registry-linked trialsOpen access · greenAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 1,152 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,152citing papers in PubMed, 3 pooled it
79.0field-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.

NCT02972554 phase4completednot on this mapstarted 2016, after this paper: background citation

Beta-Blockers and Inflammatory Responses to Acute Psychosocial Stress

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2016 to 2017Enrolled92ConditionsStress, Psychological, Inflammation, Cortisol, Sympathetic Nervous SystemArmsPropanolol hydrochloride, Placebo
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

1,152 citing papers in PubMed, 3 syntheses or guidelines pooled it, 2,457 citations in OpenAlex.

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1,092 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Emerging Risk Factors CollaborationEmerging Risk Factors Collaboration Coordinating Centre, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK.
Stephen Kaptoge
Emanuele Di Angelantonio
Gordon Lowe
Mark B Pepys
Simon G Thompson
Rory Collins
John Danesh

Funding

SOUTH CAROLINA CLINICAL & TRANSLATIONAL RESEARCH INSTITUTE (SCTR)UL1RR029882 · NCRR · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI BRADY, KATHLEEN T. · 2009 to 2011
$10.1M
British Heart Foundation PG/09/002/26056British Heart Foundation RG/08/013/25942British Heart Foundation RG/08/014/24067Medical Research Council G0401527Medical Research Council G0600705Medical Research Council G7900510Medical Research Council MC_U105260792Medical Research Council MC_U137686857NCRR NIH HHS UL1 RR029882
6 · The paper itself

Abstract

backgroundAssociations of C-reactive protein (CRP) concentration with risk of major diseases can best be assessed by long-term prospective follow-up of large numbers of people. We assessed the associations of CRP concentration with risk of vascular and non-vascular outcomes under different circumstances.

methodsWe meta-analysed individual records of 160 309 people without a history of vascular disease (ie, 1.31 million person-years at risk, 27 769 fatal or non-fatal disease outcomes) from 54 long-term prospective studies. Within-study regression analyses were adjusted for within-person variation in risk factor levels.

resultsLog(e) CRP concentration was linearly associated with several conventional risk factors and inflammatory markers, and nearly log-linearly with the risk of ischaemic vascular disease and non-vascular mortality. Risk ratios (RRs) for coronary heart disease per 1-SD higher log(e) CRP concentration (three-fold higher) were 1.63 (95% CI 1.51-1.76) when initially adjusted for age and sex only, and 1.37 (1.27-1.48) when adjusted further for conventional risk factors; 1.44 (1.32-1.57) and 1.27 (1.15-1.40) for ischaemic stroke; 1.71 (1.53-1.91) and 1.55 (1.37-1.76) for vascular mortality; and 1.55 (1.41-1.69) and 1.54 (1.40-1.68) for non-vascular mortality. RRs were largely unchanged after exclusion of smokers or initial follow-up. After further adjustment for fibrinogen, the corresponding RRs were 1.23 (1.07-1.42) for coronary heart disease; 1.32 (1.18-1.49) for ischaemic stroke; 1.34 (1.18-1.52) for vascular mortality; and 1.34 (1.20-1.50) for non-vascular mortality.

interpretationCRP concentration has continuous associations with the risk of coronary heart disease, ischaemic stroke, vascular mortality, and death from several cancers and lung disease that are each of broadly similar size. The relevance of CRP to such a range of disorders is unclear. Associations with ischaemic vascular disease depend considerably on conventional risk factors and other markers of inflammation.

fundingBritish Heart Foundation, UK Medical Research Council, BUPA Foundation, and GlaxoSmithKline.

Indexed as

Risk AssessmentAlcohol DrinkingBiomarkersBlood PressureBody Mass IndexCholesterolCoronary DiseaseC-Reactive ProteinDatabases, FactualDiabetes MellitusFemaleFibrinogenHumansInterleukin-6Leukocyte CountLung DiseasesBiomarkersCholesterolC-Reactive ProteinFibrinogenInterleukin-6Serum AlbuminTriglycerides

Identifiers

PMID20031199
PMCPMC3162187
OpenAlexW1812416290

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.