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Meta-Analysis
. 2022 Feb;50(2):3000605221079547.
doi: 10.1177/03000605221079547.

Predictive role of C-reactive protein in sudden death: a meta-analysis of prospective studies

Ruhua Zhou  1 , Jingjing Xu  2 , Jiaochen Luan  2 , Weiyun Wang  2 , Xinzhi Tang  1 , Yanling Huang  3 , Ziwen Su  1 , Lei Yang  3 , Zejuan Gu  2
Affiliations
Meta-Analysis

Predictive role of C-reactive protein in sudden death: a meta-analysis of prospective studies

Ruhua Zhou et al. J Int Med Res. 2022 Feb.

Abstract

Objective: C-reactive protein (CRP) is a powerful predictor of and risk factor for cardiovascular disease. However, the relationship between CRP and sudden death (SD) is controversial. Therefore, we performed a meta-analysis to evaluate the association between CRP and SD.

Methods: We conducted a comprehensive search of the databases of PubMed, Web of Science, Embase, Cochrane Library, Wanfang, CNKI, China Biology Medicine disc, and Weipu. Two researchers independently screened the literature, extracted data, and evaluated the data quality. The overall effect size was meta-analyzed using Stata software version 12.0 (StataCorp, College Station, TX, USA).

Results: Twelve prospective studies involving 36,646 patients were included in the present meta-analysis. The data revealed that patients with higher CRP concentrations had a greater risk of SD (hazard ratio, 1.19; 95% confidence interval, 1.09-1.29). When the hazard ratio of SD was calculated by multivariate analysis of nine studies, CRP was confirmed to be an independent predictive factor for SD (hazard ratio, 1.05; 95% confidence interval, 1.03-1.07).

Conclusions: This meta-analysis confirmed that CRP is an independent predictor of SD. These results support the recommendation of recording the CRP concentration for risk assessment of SD in clinical practice.

Keywords: C-reactive protein; cardiovascular disease INPLASY registration number: INPLASY2021110074.; meta-analysis; predictive factor; risk factor; sudden death.

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Conflict of interest statement

Declaration of conflict of interest: The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Study selection process.
Figure 2.
Figure 2.
Forest plots for the association between CRP and SD. (a) Association between CRP and SD. (b) Subgroup analysis: HR calculated by multivariate analysis and univariate analysis. CRP, C-reactive protein; SD, sudden death; HR, hazard ratio; CI, confidence interval.
Figure 3.
Figure 3.
Forest plots for the association between CRP and SD. (a) Subgroup analysis of the association between CRP and SD according to primary disease. (b) Subgroup analysis of CRP and SD according to outcome. (c) Subgroup analysis of CRP and SD according to cut-off value of CRP. CRP, C-reactive protein; SD, sudden death; HR, hazard ratio; CI, confidence interval.
Figure 4.
Figure 4.
Sensitivity analysis for this meta-analysis.
Figure 5.
Figure 5.
Publication bias in the meta-analysis (Beggʼs test, p = 0.193).
See this image and copyright information in PMC

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