Evidence map›Paper›PMID 34753497›Full record

ArticleCardiovascular diabetology2021

Low-grade inflammation as a risk factor for cardiovascular events and all-cause mortality in patients with type 2 diabetes.

Shahnam Sharif, Y Van der Graaf, M J Cramer, L J Kapelle, G J de Borst, Frank L J Visseren, Jan Westerink, SMART study group

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
104citing papers in PubMed, 1 pooled it
19.3field-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.

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

104 citing papers in PubMed, 1 synthesis or guideline pooled it, 196 citations in OpenAlex.

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44 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

8 authors at 2 institutions in 1 country.

Shahnam SharifDepartment of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500 F02.126, Utrecht, 3508 GA, The Netherlands.
Y Van der GraafJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
M J CramerDepartment of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
L J KapelleDepartment of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.
G J de BorstDepartment of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Frank L J VisserenDepartment of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500 F02.126, Utrecht, 3508 GA, The Netherlands.
Jan WesterinkDepartment of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500 F02.126, Utrecht, 3508 GA, The Netherlands. J.Westerink-3@umcutrecht.nl.ORCID 0000-0001-5021-5227
SMART study group
University Medical Center Utrecht · NLUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundType 2 diabetes is a condition associated with a state of low-grade inflammation caused by adipose tissue dysfunction and insulin resistance. High sensitive-CRP (hs-CRP) is a marker for systemic low-grade inflammation and higher plasma levels have been associated with cardiovascular events in various populations. The aim of the current study is to evaluate the relation between hs-CRP and incident cardiovascular events and all-cause mortality in high-risk type 2 diabetes patients.

methodsProspective cohort study of 1679 type 2 diabetes patients included in the Second Manifestations of ARTerial disease (SMART). Cox proportional hazard models were used to evaluate the risk of hs-CRP on cardiovascular events (composite of myocardial infarction, stroke and vascular mortality) and all-cause mortality. Hs-CRP was log-transformed for continuous analyses. Findings were adjusted for age, sex, BMI, current smoking and alcohol use, non-HDL-cholesterol and micro-albuminuria.

results307 new cardiovascular events and 343 deaths occurred during a median follow-up of 7.8 years (IQR 4.2-11.1). A one unit increase in log(hs-CRP) was related to an increased vascular- and all-cause mortality risk (HR 1.21, 95% CI 1.01-1.46 and HR 1.26, 95% CI 1.10-1.45 respectively). No relation was found between log(hs-CRP) and myocardial infarction or stroke. The relations were similar in patients with and without previous vascular disease.

conclusionLow grade inflammation, as measured by hs-CRP, is an independent risk factor for vascular- and all-cause mortality but not for cardiovascular events in high-risk type 2 diabetes patients. Chronic low-grade inflammation may be a treatment target to lower residual cardiovascular risk in type 2 diabetes patients.

Indexed as

AgedBiomarkersBlood GlucoseCardiovascular DiseasesCause of DeathC-Reactive ProteinDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHeart Disease Risk FactorsHumansIncidenceInflammationInflammation MediatorsLipidsMaleBiomarkersBlood GlucoseC-Reactive ProteinGlycated Hemoglobinhemoglobin A1c protein, humanInflammation MediatorsLipids

Identifiers

PMID34753497
PMCPMC8579639
OpenAlexW3213397314

What OpenQuestion holds

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LicenceCC BY
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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.