C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function

Vrsalović, Mislav; Vučur, Ksenija; Car, Boris; Krčmar, Tomislav; Presečki, Ana Vrsalović

doi:10.3325/cmj.2015.56.351

Cited by 24 publications

(14 citation statements)

References 19 publications

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“…PAD is a marker of advanced atherosclerosis, and polyvascular involvement is often present in PAD patients . Diabetes accelerates atherosclerosis by mechanisms that include increased platelet activity, increased levels of coagulation factors, and inflammatory biomarkers .…”

Section: Discussionmentioning

confidence: 99%

Impact of diabetes on mortality in peripheral artery disease: a meta‐analysis

Vrsalović

Vučur

Presečki

et al. 2016

Clinical Cardiology

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Background There are accumulating studies showing the association between diabetes and all‐cause mortality in peripheral vascular disease. However, the results in these studies are conflicting regarding the impact of diabetes on outcome. Hypothesis Diabetes is associated with increased risk of mortality in peripheral artery disease. Methods Using MEDLINE and Scopus, we searched for studies published before January 2016. Additionally, studies were identified by manual search of references of original articles or review studies on this topic. Of the 1072 initially identified records, 21 studies with 15,857 patients were included in the final analysis. Results Diabetes was associated with a statistically significant increased risk of all‐cause mortality (odds ratio: 1.89, 95% confidence interval: 1.51‐2.35, P < 0.001), without detected publication bias (Egger bias = 0.75, P = 0.631). The stronger effect on outcome was obtained in patients with critical limb ischemia (odds ratio: 2.38, 95% confidence interval: 1.22‐4.63, P < 0.001) as the most severe form of peripheral vascular disease. Conclusions Diabetes is associated with an increased risk of mortality in peripheral vascular disease, and the effect is even more pronounced in patients with critical limb ischemia.

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Section: Discussionmentioning

confidence: 99%

Impact of diabetes on mortality in peripheral artery disease: a meta‐analysis

Vrsalović

Vučur

Presečki

et al. 2016

Clinical Cardiology

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“…A total of three studies [13][14][15] assessed the relationship between CRP as a categorical variable and the risk of long-term adverse CV outcomes (Fig. 4a).…”

Section: Cardiovascular Outcomesmentioning

confidence: 99%

Diagnostic and prognostic value of serum C-reactive protein in heart failure with preserved ejection fraction: a systematic review and meta-analysis

et al. 2020

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Heart failure (HF) is a major epidemic with rising morbidity and mortality rates that encumber global healthcare systems. While some studies have demonstrated the value of CRP in predicting (i) the development of HFpEF and (ii) long-term clinical outcomes in HFpEF patients, others have shown no such correlation. As a result, we conducted the following systematic review and meta-analysis to assess both the diagnostic and prognostic role of CRP in HFpEF. PubMed and Embase were searched for studies that assess the relationship between CRP and HFpEF using the following search terms: (((C-reactive protein) AND ((preserved ejection fraction) OR (diastolic heart failure))). The search period was from the start of database to August 6, 2019, with no language restrictions. A total of 312 and 233 studies were obtained from PubMed and Embase respectively, from which 19 studies were included. Our meta-analysis demonstrated the value of a high CRP in predicting the development of not only new onset HFpEF (HR: 1.08; 95% CI: 1.00-1.16; P = 0.04; I 2 = 22%), but also an increased risk of cardiovascular mortality when used as a categorical (HR: 2.52; 95% CI: 1.61-3.96; P < 0.0001; I 2 = 19%) or a continuous variable (HR: 1.24; 95% CI: 1.04-1.47; P = 0.01; I 2 = 28%), as well as all-cause mortality when used as a categorical (HR: 1.78; 95% CI: 1.53-2.06; P < 0.00001; I 2 = 0%) or a continuous variable: (HR: 1.06; 95% CI: 1.02-1.06; P = 0.003; I 2 = 61%) in HFpEF patients. CRP can be used as a biomarker to predict the development of HFpEF and long-term clinical outcomes in HFpEF patients, in turn justifying its use as a simple, accessible parameter to guide clinical management in this patient population. However, more prospective studies are still required to not only explore the utility and dynamicity of CRP in HFpEF but also to determine whether risk stratification algorithms incorporating CRP actually provide a material benefit in improving patient prognosis.

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“…PAD is a marker of advanced atherosclerotic disease. 14,15 Because involvement of multiple vascular territories (and frequently associated CAD) is often present in PAD patients, these patients have an increased risk for CV ischemic events and CV death. 16 They represent a population at high CV risk that is comparable to individuals with previous MI, coronary revascularization, and other arterial revascularization procedures.…”

Section: Quantitative Data Synthesismentioning

confidence: 99%

Atrial fibrillation and risk of cardiovascular events and mortality in patients with symptomatic peripheral artery disease: A meta‐analysis of prospective studies

Vrsalović

Presečki

2017

Clinical Cardiology

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Background Atrial fibrillation (AF) is associated with adverse outcomes in terms of survival and morbidity. Peripheral artery disease (PAD) and AF share several common risk factors and often coexist. Whether AF has a prognostic role in patients with PAD has not been extensively studied. Hypothesis AF is associated with major adverse cardiac events (MACE) and mortality in symptomatic PAD patients. Methods Using MEDLINE and Scopus, we searched for studies published before December 2016 that evaluated cardiovascular outcomes based on the presence/absence of AF in a prospective manner with a follow‐up period of ≥12 months. The outcomes were reported using a random‐effects model, and heterogeneity was assessed using the I2 statistic. Sensitivity analyses were performed to test the contribution of each study to the overall results. Results Six prospective studies (Newcastle‐Ottawa score range, 7–9) with 14 656 patients were included in the final analysis (age range, 66–70 years; median follow‐up, 1.4 years). Our pooled analysis found a significant association between AF and mortality (odds ratio: 2.52, 95% confidence interval: 1.91‐3.34, I2 = 32.6%), without evidence of publication bias (P = 0.63). Meta‐analysis showed a significant impact of AF on MACE (odds ratio: 2.54, 95% confidence interval: 1.78‐3.63, I2 = 74.3%), without detected publication bias (P = 0.08). Conclusions AF is associated with increased risk of mortality and MACE in symptomatic PAD.

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C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease and preserved left ventricular systolic function

Cited by 24 publications

References 19 publications

Impact of diabetes on mortality in peripheral artery disease: a meta‐analysis

Impact of diabetes on mortality in peripheral artery disease: a meta‐analysis

Diagnostic and prognostic value of serum C-reactive protein in heart failure with preserved ejection fraction: a systematic review and meta-analysis

Atrial fibrillation and risk of cardiovascular events and mortality in patients with symptomatic peripheral artery disease: A meta‐analysis of prospective studies

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