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Heart 96:339-346 doi:10.1136/hrt.2009.174912
  • Systematic review

Early C-reactive protein in the prediction of long-term outcomes after acute coronary syndromes: a meta-analysis of longitudinal studies

Table 2

Pooled RRs for adverse cardiovascular outcomes by subgroups of study variable

Subgroups C-reactive protein groups
≤3.0 mg/l 3.1∼10.0 mg/l >10.0 mg/l
Referent N RR (95% CI) N RR (95% CI)
Overall 1.00 125–7 9–11 14 16 19 21 22 24 1.40 (1.18 to 1.67) 116 7 9–11 14 15 19 21 22 24 2.18 (1.77 to 2.68)
Outcome
 Heart failure 1.00 36 11 21 1.72 (1.17 to 2.55) 36 11 21 2.89 (2.07 to 4.02)
 Cardiac death 1.00 37 14 24 1.19 (0.80 to 1.77) 37 14 24 2.10 (1.50 to 2.92)
 All-cause death 1.00 95–7 9 11 14 19 21 24 1.49 (1.21 to 1.84) 85–7 9 11 14 21 24 2.50 (2.12 to 2.96)
 p for heterogeneity 0.42 0.41
Time for blood samples obtained from the onset of symptoms
 ≤24 h 1.00 95–7 10 11 14 16 21 24 1.39 (1.11 to 1.74) 76 7 10 11 14 21 24 2.34 (1.92 to 2.85)
 >24 h or on admission 1.00 39 19 22 1.43 (1.08 to 1.88) 49 15 19 22 1.92 (1.26 to 2.95)
 p for heterogeneity 0.86 0.42
Follow-up year
 >1 year 1.00 69–11 14 21 24 1.32 (1.04 to 1.69) 79–11 14 15 21 24 2.18 (1.77 to 2.69)
 ≤1 year 1.00 65–7 16 19 22 1.49 (1.16 to 1.91) 46 7 19 22 2.19 (1.36 to 3.52)
 p for heterogeneity 0.51 0.99
Region
 Europe 1.00 77 9 10 14 16 22 24 1.26 (1.01 to 1.57) 77 9 10 14 15 22 24 1.83 (1.46 to 2.29)
 Non-Europe 1.00 55 6 11 19 21 1.67 (1.26 to 2.21) 46 11 19 21 2.81 (2.25 to 3.52)
 p for heterogeneity 0.12 0.01
Confounder adjustments*
 Unadjusted 1.00 66 10 11 14 21 24 1.54 (1.19 to 1.99) 76 10 11 14 15 21 24 3.53 (2.54 to 4.91)
 Adjusted 1.00 66 10 11 14 21 24 1.36 (1.05 to 1.76) 76 10 11 14 15 21 24 2.31 (1.78 to 3.00)
 p for heterogeneity 0.52 0.05
Mean age
 <65 y 1.00 65 7 11 19 21 24 1.55 (1.20 to 2.00) 67 11 15 19 21 24 2.23 (1.68 to 2.98)
 ≥65 y 1.00 76 9–11 14 16 22 1.33 (1.08 to 1.64) 66 9–11 14 22 2.15 (1.65 to 2.80)
 p for heterogeneity 0.37 0.85
Study quality
 High 1.00 66 7 10 14 21 24 1.21 (0.90 to 1.62) 66 7 10 14 21 24 2.31 (1.84 to 2.91)
 Low 1.00 65 9 11 16 19 22 1.52 (1.23 to 1.89) 59 11 15 19 22 2.01 (1.43 to 2.83)
 p for heterogeneity 0.21 0.51
Original study design
 Cohort 1.00 85–7 7 9–11 21 24 1.42 (1.13 to 1.78) 86 7 9–11 15 21 24 2.18 (1.74 to 2.72)
 Trial 1.00 414 16 19 22 1.39 (1.06 to 1.82) 314 19 22 2.13 (1.24 to 3.67)
 p for heterogeneity 0.91 0.94
  • * The results were from the articles that provided both crude and adjusted RRs (95% CIs).

  • High quality was defined as articles that met four or more of the six quality criteria. Low quality was defined as articles that met three or fewer of the six quality criteria.

  • N, number of the study.

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