ArticleJournal of atherosclerosis and thrombosis2023
Elevated Levels of Serum Alkaline Phosphatase are Associated with Increased Risk of Cardiovascular Disease: A Prospective Cohort Study.
Article in Journal of atherosclerosis and thrombosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Association between risk of ischemic stroke and liver enzymes levels: a systematic review and meta-analysis.BMC neurology · 2025Pooled it
- Serum liver enzymes and risk of stroke: Systematic review with meta-analyses and Mendelian randomization studies.European journal of neurology · 2024Pooled it
- Preliminary Assessment of Red Beetroot Supplementation and Cultivar Effects in Low-Protein-Fed WKY Rats.Nutrients · 2026Article
- Association between cardiometabolic index and liver function parameters: Analysis of NHANES 2007 to 2018.Medicine · 2026Article
- Liver fraction of circulating alkaline phosphatase is elevated in chronic kidney disease and associates with mortality in patients treated with haemodialysis.Clinical kidney journal · 2026Article
- Moderate-severe aortic arch calcification and high serum alkaline phosphatase co-modify the risk of cardiovascular events and mortality among chronic hemodialysis patients.Renal failure · 2025Article
- From deep learning discovery to clinical validation: a new composite marker predicts mortality in type 2 diabetes.Cardiovascular diabetology. Endocrinology reports · 2025Article
- Considerations on the Development of Therapeutics in Vascular Calcification.Journal of cardiovascular development and disease · 2025Review
- Optimization of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin therapy for Japanese patients with urothelial carcinoma.Japanese journal of clinical oncology · 2025Article
- Author response to: OSIN-D-24-01898: Comment on "Association of serum alkaline phosphatase levels with bone mineral density, osteoporosis prevalence, and mortality in US adults with osteoporosis: evidence from NHANES 2005-2018".Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Thromboembolism in adult patients with acute promyelocytic leukemia: clinical characteristics, risk factors, and a predictive nomogram.Annals of hematology · 2025Article
- Alkaline phosphatase predicts short-term postoperative outcome in adult patients with moyamoya disease.Frontiers in neurology · 2025Article
- Morphological changes and their associations with clinical parameters in children with nephropathic cystinosis and chronic kidney disease prior to kidney replacement therapy over 25 years.Pediatric nephrology (Berlin, Germany) · 2024Article
- Impact of alkaline phosphatase on clinical outcomes in patients with ischemic stroke: a nationwide registry analysis.Frontiers in neurology · 2024Article
- A novel, machine-learning model for prediction of short-term ASCVD risk over 90 and 365 days.Frontiers in digital health · 2024Article
- Alkaline phosphatase and mortality in stroke patients: a systematic review.Annals of translational medicine · 2023Review
- Serum alkaline phosphatase levels at admission are associated with unfavorable prognosis in acute ischemic stroke patients undergoing endovascular thrombectomy.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimWe aimed to investigate the associations of serum alkaline phosphatase (ALP) levels with incident cardiovascular disease (CVD), coronary heart disease (CHD), and stroke, as well as their subtypes, among men and women in a prospective cohort study.
methodsA total of 11,408 men and 14,981 women were included to evaluate the associations between ALP levels and incident CVD. Participants were divided into four groups according to the quartiles of serum ALP levels in men and women separately. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).
resultsDuring an average follow-up of 7.3 years, 7,015 incident CVDs (5,561 CHDs and 1,454 strokes) were documented. After adjustments for age, body mass index, smoking status, drinking status, diabetes, hyperlipidemia, hypertension, physical activity, aspirin usage, anticoagulants usage, menopausal status (women only), family history of CVD, estimated glomerular filtration rate, white blood cell counts, and admission batch and comparing the lowest quartile of ALP, the adjusted HRs (95% CIs) of participants in the highest quartile were 1.22 (1.11-1.34) for CVD, 1.14 (1.02-1.28) for CHD, 1.43 (1.18-1.73) for stroke, 1.31 (1.09-1.57) for acute coronary syndrome (ACS), 1.37 (1.11-1.70) for ischemic stroke, and 1.75 (1.10-2.79) for hemorrhagic stroke in men and 1.12 (1.01-1.23) for CVD, 1.10 (0.99-1.23) for CHD, 1.18 (0.92-1.51) for stroke, 1.23 (1.03-1.47) for ACS, 1.10 (0.83-1.45) for ischemic stroke, and 1.54 (0.90-2.65) for hemorrhagic stroke in women. The ALP-CVD associations remained significant even within the normal ranges of ALP levels (40-150 U/L). Moreover, linear dose-response relationships were found between ALP levels and incident CVD.
conclusionsHigher ALP levels, even within the normal range, were significantly associated with increased risks of CVD, in a dose-dependent manner. These findings suggested that regular monitoring of ALP levels may help in improving the early identification of the population at higher CVD risk.
Indexed as
Identifiers
What OpenQuestion holds
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.