ArticleAmerican journal of epidemiology2011
Free protein S level as a risk factor for coronary heart disease and stroke in a prospective cohort study of healthy United Kingdom men.
Article in American journal of epidemiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of Advanced Biomarkers for Predicting Incident Cardiovascular Disease among Asymptomatic Middle-Aged Adults.International journal of molecular sciences · 2022Pooled it
- Multi-omics integration predicts the incidence of 17 diseases in the UK Biobank.Nature communications · 2026Article
- Multi-omics integration predicts 17 disease incidences in the UK Biobank.medRxiv : the preprint server for health sciences · 2025Article
- The Link between Arterial Atherosclerotic Disease and Venous Thromboembolic Disease.Current vascular pharmacology · 2025Review
- Effect of Breastfeeding Duration on Coagulation in Women With and Without History of Gestational Diabetes Mellitus.The Journal of clinical endocrinology and metabolism · 2024Article
- Ramadan intermittent fasting is associated with improved anticoagulant activity among healthy people: a case-control study.Scientific reports · 2024Article
- Association of Nitric Oxide Synthase Polymorphism and Coagulopathy in Patients with Osteonecrosis of the Femoral Head.Journal of clinical medicine · 2022Article
- Rivaroxaban in Recurrent Ischemic Stroke Due to Protein S Deficiency: A Case Report.Neurology and therapy · 2021Article
- Vitamin K, Vascular Calcification, and Chronic Kidney Disease: Current Evidence and Unanswered Questions.Current developments in nutrition · 2019Review
- TAM receptors in cardiovascular disease.Cardiovascular research · 2019Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
Plasma protein S (PS) levels are reportedly low in patients with venous thrombosis but high in coronary heart disease (CHD) patients. The authors examined the association between free PS concentration and CHD or stroke risk and assessed risk in combination with C-reactive protein (CRP) levels. Free PS concentration was determined in 6 annual visits among 3,052 middle-aged (49-64 years) United Kingdom men from the Second Northwick Park Heart Study, with 297 CHD events from 1989 to 2005. The highest (vs. first) quintile was associated with a significantly increased CHD risk after adjustment for all other risk factors and correction for regression dilution bias (hazard ratio = 1.85, 95% confidence interval: 1.08, 3.16; P = 0.024). Models that included all well-known risk factors plus PS quintiles improved prediction of CHD (net reclassification improvement (NRI) = 7.0% (P = 0.007), category-less NRI (>0) = 22.1% (P < 0.001)), and the likelihood ratio statistic increased significantly (P = 0.018). The increase in CHD risk was particularly strong when subjects also had high CRP levels. There was no association between free PS level and stroke risk. This study confirms the independent association of elevated free PS levels with future risk of CHD, although elevated PS levels added only modestly to prediction metrics. The novel finding of increased CHD risk, particularly when CRP and PS levels are high, requires further study.
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