Evidence map›Paper›PMID 24523037›Full record

Trial reportStroke2014

C-reactive protein as a prognostic marker after lacunar stroke: levels of inflammatory markers in the treatment of stroke study.

Mitchell S V Elkind, Jorge M Luna, Leslie A McClure, Yu Zhang, Christopher S Coffey, Ana Roldan, Oscar H Del Brutto, Edwin Javier Pretell, L Creed Pettigrew, Brett C Meyer and 4 more

Registry-linked trialOpen access · bronzeAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00059306 (Secondary Prevention of Small Subcortical Strokes), which is not on this map. Cited by 57 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 2 pooled it
5.4field-weighted citation impact, top 4% 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.

NCT00059306 phase3completednot on this map

Secondary Prevention of Small Subcortical Strokes (SPS3) Trial

TypeinterventionalSponsorUniversity of British ColumbiaRan2003 to 2012Enrolled3,020ConditionsCerebrovascular Accident, HypertensionArmsaspirin, clopidogrel, Target of Blood Pressure, placebo
3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 103 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  9. Review
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  12. Targeting inflammation to reduce recurrent stroke.International journal of stroke : official journal of the International Stroke Society · 2024
    Review
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  16. Article
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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

14 authors at 20 institutions in 22 countries.

Mitchell S V ElkindFrom the Department of Neurology, College of Physicians and Surgeons (M.S.V.E., J.M.L.), Department of Epidemiology, Mailman School of Public Health (M.S.V.E., J.M.L.), and Gertrude H. Sergievsky Center (M.S.V.E.), Columbia University, New York, NY; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL (L.A.M., Y.Z.); Department of Biostatistics, University of Iowa, Iowa City, IA (C.S.C.); Department of Neurology, University of Texas at Houston, Houston, TX (A.R.); School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador (O.H.D.B.); Department of Neurology, Hospital Alberto Sabogal, Lima, Peru (E.J.P.); Department of Neurology, University of Kentucky, Lexington, KY (L.C.P.); Department of Neurology, University of San Diego, San Diego, CA (B.C.M.); Department of Neurology, Pontificia Universidad Católica de Chile, Santiago, Chile (J.T.); School of Nursing and Secondary Prevention of Small Subcortical Strokes (SPS3) Coordinating Center, University of Texas Health Science Center at San Antonio, San Antonio, TX (C.W.); and Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada (O.R.B.).
Jorge M Luna
Leslie A McClure
Yu Zhang
Christopher S Coffey
Ana Roldan
Oscar H Del Brutto
Edwin Javier Pretell
L Creed Pettigrew
Brett C Meyer
Jorge Tapia
Carole White
Oscar R Benavente
LIMITS Investigators
University of Alabama at Birmingham · USRichard Wolf (Germany) · DEKelly Services (United States) · USDean College · USADRIA Développement · FRAmerican Nephrology Nurses Association · USAnderson University - South Carolina · USAtkins (United Kingdom) · GBBailey Tool & Manufacturing (United States) · USBell (Canada) · CABerger (Canada) · CABerman Group (Czechia) · CZBrandywine Photonics (United States) · USCampo Arqueologico de Mertola · PTCentre Hospitalier Régional et Universitaire de Nancy · FRCervantes Institute · ESCharles River Laboratories (Netherlands) · NLCleary University · USClínica Santa María · COCogent (United Kingdom) · GB

Funding

University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Kirk Michael Habegger · 2013 to 2026
$19.5M
Levels of Inflammatory Markers in Treatment of StrokeR01NS050724 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI ELKIND, MITCHELL S · 2005 to 2008
$1.2M
NIDDK NIH HHS P30 DK079626NINDS NIH HHS R01 NS050724
6 · The paper itself

Abstract

background and purposeInflammatory biomarkers predict incident and recurrent cardiac events, but their relationship to stroke prognosis is uncertain. We hypothesized that high-sensitivity C-reactive protein (hsCRP) predicts recurrent ischemic stroke after recent lacunar stroke.

methodsLevels of Inflammatory Markers in the Treatment of Stroke (LIMITS) was an international, multicenter, prospective ancillary biomarker study nested within Secondary Prevention of Small Subcortical Strokes (SPS3), a phase III trial in patients with recent lacunar stroke. Patients were assigned in factorial design to aspirin versus aspirin plus clopidogrel, and higher versus lower blood pressure targets. Patients had blood samples collected at enrollment and hsCRP measured using nephelometry at a central laboratory. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for recurrence risks before and after adjusting for demographics, comorbidities, and statin use.

resultsAmong 1244 patients with lacunar stroke (mean age, 63.3±10.8 years), median hsCRP was 2.16 mg/L. There were 83 recurrent ischemic strokes (including 45 lacunes) and 115 major vascular events (stroke, myocardial infarction, and vascular death). Compared with the bottom quartile, those in the top quartile (hsCRP>4.86 mg/L) were at increased risk of recurrent ischemic stroke (unadjusted HR, 2.54; 95% CI, 1.30-4.96), even after adjusting for demographics and risk factors (adjusted HR, 2.32; 95% CI, 1.15-4.68). hsCRP predicted increased risk of major vascular events (top quartile adjusted HR, 2.04; 95% CI, 1.14-3.67). There was no interaction with randomized antiplatelet treatment.

conclusionsAmong recent lacunar stroke patients, hsCRP levels predict the risk of recurrent strokes and other vascular events. hsCRP did not predict the response to dual antiplatelets. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059306.

Indexed as

AgedAntihypertensive AgentsAspirinBiomarkersBlood PressureClopidogrelCohort StudiesConfidence IntervalsC-Reactive ProteinFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsInflammation MediatorsMaleMiddle AgedPhlebotomyAntihypertensive AgentsAspirinBiomarkersClopidogrelC-Reactive ProteinHydroxymethylglutaryl-CoA Reductase InhibitorsInflammation MediatorsPlatelet Aggregation InhibitorsTiclopidineC-reactive proteininflammationprognosisstroke

Identifiers

PMID24523037
PMCPMC4114338
OpenAlexW2026525159

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.