Evidence mapPaperPMID 32640905Full record

SynthesisArteriosclerosis, thrombosis, and vascular biology2020

Plasma Biomarkers to Predict Cardiovascular Outcome in Patients With Peripheral Artery Disease: A Systematic Review and Meta-Analysis.

Bram Kremers, Lina Wübbeke, Barend Mees, Hugo Ten Cate, Henri Spronk, Arina Ten Cate-Hoek

Open access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Arteriosclerosis, thrombosis, and vascular biology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 2 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.

  1. Pooled it
  2. The Association of Neutrophil-Lymphocyte Ratio with Venous Thromboembolism: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Article
  8. Implications of inflammation and sex in lower extremity arterial disease.European journal of clinical investigation · 2026
    Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Lipidomic insights on abdominal aortic aneurysm and peripheral arterial disease.Journal of molecular medicine (Berlin, Germany) · 2025
    Review
  17. Article
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Bram KremersFrom the Laboratory for Clinical Thrombosis and Hemostasis, Department of Biochemistry, Maastricht University, the Netherlands (B.K., H.t.C., H.S., A.t.C.-H.).
Lina WübbekeDepartment of Vascular Surgery (L.W., B.M.), Maastricht University Medical Center, the Netherlands.
Barend MeesDepartment of Vascular Surgery (L.W., B.M.), Maastricht University Medical Center, the Netherlands.
Hugo Ten CateFrom the Laboratory for Clinical Thrombosis and Hemostasis, Department of Biochemistry, Maastricht University, the Netherlands (B.K., H.t.C., H.S., A.t.C.-H.).
Henri SpronkFrom the Laboratory for Clinical Thrombosis and Hemostasis, Department of Biochemistry, Maastricht University, the Netherlands (B.K., H.t.C., H.S., A.t.C.-H.).
Arina Ten Cate-HoekFrom the Laboratory for Clinical Thrombosis and Hemostasis, Department of Biochemistry, Maastricht University, the Netherlands (B.K., H.t.C., H.S., A.t.C.-H.).
Maastricht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePatients with lower extremity peripheral artery disease (PAD) are at increased risk of major adverse cardiovascular events. Numerous plasma biomarkers have been investigated in lower extremity PAD, but none are used for clinical risk assessment. We aimed to provide a comprehensive overview of biomarker testing in PAD as a first step to improve risk stratification. Approach and Results: A systematic literature review in MEDLINE/PubMed, Cochrane, and Embase was performed, identifying all studies investigating plasma biomarkers in association with cardiovascular events and mortality in lower extremity PAD. Forty-seven studies comprising 21 473 PAD patients met our criteria and were included. Effect estimates were provided by the studies based on a minimum follow-up of 1 year. Meta-analyses were performed by pooling studies per biomarker for each end point. Patients with increased high-sensitivity CRP (C-reactive protein) levels had a relative risk of 1.86 (1.48-2.33) for major adverse cardiovascular events and a relative risk of 3.49 (2.35-5.19) for mortality. Increased fibrinogen and d-dimer levels were associated with an increased relative risk of mortality of 2.08 (1.46-2.97) and 2.22 (1.24-3.98), respectively. Additionally, patients with increased NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity cTnT (cardiac troponin T) levels were at an even higher risk of mortality with relative risks of 4.50 (2.98-6.81) and 3.33 (2.70-4.10), respectively.

conclusionsThis systematic review identifies promising biomarkers representing different pathophysiological processes implicated in lower extremity PAD, including high-sensitivity CRP, neutrophil-lymphocyte ratio, fibrinogen, d-dimer, NT-proBNP, and high-sensitivity cTnT. Clinical implementation should be preceded by a management study to test the utility of a combination of these markers for individual risk stratification. Ultimately, this may contribute to tailored treatment and increased effectiveness of current treatment strategies in PAD.

Indexed as

AgedBiomarkersClinical Decision-MakingFemaleHumansMaleMiddle AgedPeripheral Arterial DiseasePredictive Value of TestsPrognosisRisk AssessmentRisk FactorsBiomarkerslower extremitymeta-analysispeptide fragmentsperipheral artery diseaserisk assessment

Identifiers

PMID32640905
PMCPMC7447177
OpenAlexW3041275745

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.