高敏c反应蛋白（hs-crp）在预测未来心血管事件中的预后价值：一项系统综述和荟萃分析

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-09-01 DOI:10.1016/j.ajpc.2025.101166

Moiuz Chaudhri MD , Ahmed Al Mahrizi BS , Barira Haroon BS , Michael Acevedo BS , Arjun Ramachandran BS , Laith Rahabneh MD , Ambica Nair MD , Christian Kaunzinger MD , Arthur Okere MD

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引用次数: 0

摘要

炎症在动脉粥样硬化和心血管事件中起着核心作用。高敏c反应蛋白（hs-CRP）是一种普遍存在的全身性炎症的生物标志物，由于其在已知危险因素之外增强心血管风险预测的能力而引起了预防心脏病学家的注意。但其在异质人群和研究设计中的预后意义尚不确定。为了填补这一空白，我们进行了系统回顾和荟萃分析，以调查成人高hs-CRP水平与随后增加的心血管事件风险之间的关系。方法本研究遵循PRISMA 2020声明，在PROSPERO注册（CRD42025638183）。对2013年至2023年的研究进行系统检索，得出了3,644篇论文；删除248篇重复文献后，从30篇全文综述中提取数据。4项研究（n=6816）符合定量分析的纳入标准。我们纳入了报告hs-CRP升高与心血管事件之间关联的比值比（OR）和置信区间（CIs）的研究。我们进行了随机效应荟萃分析，以得出综合效应估计。结果共纳入4项研究，6816名受试者。hs-CRP水平升高预测随后的心血管事件（OR: 1.99, 95% CI: 1.36-2.94, p = 0.0004）。存在中度异质性（I² = 66.1%,p = 0.0315）。个别研究的or范围为1.50至4.50，均具有统计学意义。结果是无症状的颈动脉狭窄、主动脉粥样硬化、缺血性卒中和冠状动脉成形术后再狭窄。结论高hs-CRP是心血管事件的独立危险因素，高hs-CRP患者发生心血管事件的可能性几乎是其两倍。这些发现巩固了其作为预防性心脏病学辅助生物标志物的作用。由于炎症的特征在不同人群中可能有所不同，因此需要更大规模、更同质的研究来改进包括炎症在内的风险预测模型。

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PROGNOSTIC VALUE OF HIGH-SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) IN PREDICTING FUTURE CARDIOVASCULAR EVENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Therapeutic Area

CVD Prevention – Primary and Secondary

Background

Inflammation plays a central role in atherosclerosis and cardiovascular events. High-sensitivity C-reactive protein (hs-CRP), a ubiquitous biomarker of systemic inflammation, has come to the attention of preventive cardiologists for its ability to enhance cardiovascular risk prediction beyond established risk factors. But its prognostic significance in heterogeneous populations and study designs is uncertain. To fill this gap, we performed a systematic review and meta-analysis to investigate association between a high hs-CRP level and subsequently increased risk for future cardiovascular events in adults.

Methods

This study adhered to the PRISMA 2020 statement and was registered in PROSPERO (CRD42025638183). A systematic search of studies from 2013 to 2023 yielded 3,644 articles; after 248 duplicates were removed, data were extracted from full-text reviews of 30. Four studies (n=6816) met inclusion criteria for quantitative analysis. We included studies that reported odds ratios (OR) with confidence intervals (CIs) for the association between elevated hs-CRP and cardiovascular events. We performed a random-effects meta-analysis to derive pooled effect estimates.

Results

They included four studies with 6,816 subjects. Elevated hs-CRP levels predicted subsequent cardiovascular events (OR: 1.99, 95% CI: 1.36–2.94, p = 0.0004). Moderate heterogeneity was found (I² = 66.1%, p = 0.0315). The individual study ORs ranged from 1.50 to 4.50 and were all statistically significant. Outcomes were asymptomatic carotid stenosis, aortic atherosclerosis, ischemic stroke, and restenosis after coronary angioplasty.

Conclusions

High hs-CRP is an independent risk factor for cardiovascular events, with those affected being almost twice as likely to suffer them. These findings solidify its role as an adjunct biomarker in preventive cardiology. Larger and more homogenous studies are needed to improve the risk prediction models including inflammation, as the traits of inflammation may vary in different populations.

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来源期刊

American journal of preventive cardiology Cardiology and Cardiovascular Medicine

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

76 days