Evidence map›Paper›PMID 33817336›Full record

ArticleEuropean stroke journal2021

Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis.

J J McCabe, E O'Reilly, S Coveney, R Collins, L Healy, J McManus, R Mulcahy, B Moynihan, T Cassidy, F Hsu and 4 more

Erratum issuedOpen access · greenAbstract read
In one paragraph

Article in European stroke journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
8.0field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 11 institutions in 3 countries.

J J McCabeHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.ORCID https://orcid.org/0000-0003-2029-1303
E O'ReillyHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
S CoveneyHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.ORCID https://orcid.org/0000-0003-1442-6320
R CollinsHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
L HealyHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
J McManusHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
R MulcahyHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
B MoynihanHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
T CassidySchool of Medicine, University College Dublin, Dublin, Ireland.
F HsuThe Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
B WorrallDepartments of Neurology and Public Health Sciences, University of Virginia, Charlottesville, VA, USA.ORCID https://orcid.org/0000-0001-9386-4091
S MurphyHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
M O'DonnellHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.
P J KellyHealth Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland.ORCID https://orcid.org/0000-0003-4772-6565
University College Dublin · IETallaght University Hospital · IECork University Hospital · IEHealth Research Board · IEMater Misericordiae University Hospital · IENational University of Ireland · IERoyal College of Surgeons in Ireland · IEUniversity Hospital Limerick · IEUniversity Hospital Waterford · IEUniversity of Virginia Health System · USWake Forest University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification.

methodsWe performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures.

resultsOf 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in log

conclusionDespite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.

Indexed as

C-reactive proteinfibrinogeninflammationinterleukin-6Ischaemic strokeprognosisrecurrencetransient ischaemic attack

Identifiers

PMID33817336
PMCPMC7995315
OpenAlexW3119555533

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.