A systematic review and meta-analysis of the association between C-reactive protein and major cardiovascular events in patients with peripheral artery disease

Singh, T.P., Morris, D.R., Smith, S., Moxon, J.V., and Golledge, J. (2017) A systematic review and meta-analysis of the association between C-reactive protein and major cardiovascular events in patients with peripheral artery disease. European Journal of Vascular and Endovascular Surgery, 54 (2). pp. 220-233.

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Abstract

Background: Patients with peripheral artery disease (PAD) are at substantial risk of cardiovascular events. There is interest in using blood markers, such as C-reactive protein (CRP), to monitor prognosis and treatment efficacy in PAD patients. The aim of this meta-analysis was to assess the association between CRP and major cardiovascular events in PAD patients.

Method: Studies evaluating the association between CRP and major cardiovascular events (myocardial infarction, stroke, cardiac revascularisation and mortality) were identified using MEDLINE and the Cochrane library. Studies that did not include participants with PAD, measure CRP, or follow-up patients for cardiovascular events were excluded. Meta-analyses of published adjusted hazard ratios (HR) were conducted using an inverse variance-weighted random effects model, and heterogeneity was assessed with the I2 index.

Results: A total of 16 studies involving 5041 participants met the inclusion criteria for the systematic review. Eight studies were included in the meta-analyses. Summary effect estimates were reported as HR comparing higher and lower quantiles, and HR per unit increase in logeCRP. PAD patients with higher CRP had a significantly greater risk of major cardiovascular events compared with those with lower CRP (HR 2.26, 95% CI 1.65–3.09, p < 0.001). The HR for major cardiovascular events was 1.38 (95% CI 1.16–1.63, p < 0.001) per unit increase in logeCRP.

Conclusions: The present findings suggest that high circulating CRP is predictive of major cardiovascular events in PAD patients.

Item ID: 49473
Item Type: Article (Research - C1)
ISSN: 1532-2165
Keywords: peripheral artery disease, C-reactive protein, biomarkers
Funders: National Health and Medical Research Council, Australia (NHMRC), Office of Health and Medical Research, Queensland Government
Projects and Grants: NHMRC 1117061
Date Deposited: 28 Jun 2017 03:55
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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