Evidence mapPaperPMID 32700639Full record

Trial reportCirculation2020

Markers of Myocardial Stress, Myocardial Injury, and Subclinical Inflammation and the Risk of Sudden Death.

Brendan M Everett, M V Moorthy, Jani T Tikkanen, Nancy R Cook, Christine M Albert

Open access · bronzeAbstract readClinical TrialMulticenter Study
In one paragraph

Trial report in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
3.4field-weighted citation impact, top 6% 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

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Wearable Flexible Sensors for Cardiovascular Disease Monitoring.Advanced materials (Deerfield Beach, Fla.) · 2026
    Review
  3. Advances in biomarkers for myocardial injury after non-cardiac surgery.Journal of anesthesia and translational medicine · 2026
    Review
  4. Synergistic antiarrhythmic mechanism of IJournal of translational medicine · 2025
    Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Management Status of Myocarditis-Related Sudden Cardiac Death.Reviews in cardiovascular medicine · 2024
    Review
  10. Review
  11. Article
  12. Article
  13. Risk stratification of sudden cardiac death: a review.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  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

5 authors at 1 institution in 1 country.

Brendan M EverettDivisions of Preventive Medicine (B.M.E., M.V.M., J.T.T., N.R.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.
M V MoorthyDivisions of Preventive Medicine (B.M.E., M.V.M., J.T.T., N.R.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Jani T TikkanenDivisions of Preventive Medicine (B.M.E., M.V.M., J.T.T., N.R.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Nancy R CookDivisions of Preventive Medicine (B.M.E., M.V.M., J.T.T., N.R.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Christine M AlbertDivisions of Preventive Medicine (B.M.E., M.V.M., J.T.T., N.R.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Brigham and Women's Hospital · US

Funding

STATISTICAL INNOVATIONS IN RISK MODELINGP01CA087969 · BRIGHAM AND WOMEN'S HOSPITAL · 2000 to 2005
$22.5M
PROSPECTIVE STUDY OF DIET AND PROSTATE CANCERP01CA055075 · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · 1991 to 2005
$22.1M
Women's Health Study: Continued Follow-upR01CA047988 · BRIGHAM AND WOMEN'S HOSPITAL · 1991 to 2005
$15.2M
BIOCHEMICAL MARKERS IN THE NURSES'HEALTH STUDY COHORTR01CA049449 · BRIGHAM AND WOMEN'S HOSPITAL · 1989 to 2005
$7.7M
Physicians Health Study II: Prevention Trial of VitaminsR01CA097193 · BRIGHAM AND WOMEN'S HOSPITAL · 2002 to 2005
$6.2M
TRIAL OF ANTIOXIDANT THERAPY OF CVD IN WOMENR01HL046959 · BRIGHAM AND WOMEN'S HOSPITAL · 1993 to 2005
$3.6M
RISK FACTORS FOR CVD IN WOMENR01HL034594 · TULANE UNIVERSITY OF LOUISIANA · 1985 to 2025
$3.5M
DIETARY ETIOLOGIES OF HEART DISEASE AND CANCERR01HL035464 · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · 1986 to 2005
$2.2M
Genetic Determinants of Sudden Cardiac DeathR01HL068070 · BRIGHAM AND WOMEN'S HOSPITAL · 2003 to 2005
$1.7M
TRIAL OF VITAMIN E, BETA-CAROTENE &ASPRIN IN WOMENR01HL043851 · BRIGHAM AND WOMEN'S HOSPITAL · 1991 to 2000
$1.6M
Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2025 to 2025
$1.5M
Women's Health Study: Continued Follow-UpR01HL080467 · BRIGHAM AND WOMEN'S HOSPITAL · 2005 to 2005
$889k
NCI NIH HHS P01 CA055075NCI NIH HHS P01 CA087969NCI NIH HHS R01 CA034944NCI NIH HHS R01 CA040360NCI NIH HHS R01 CA047988NCI NIH HHS R01 CA049449NCI NIH HHS R01 CA097193NCI NIH HHS U01 CA167552NCI NIH HHS U01 CA182913NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA186107NHLBI NIH HHS K08 HL003783NHLBI NIH HHS R01 HL026490NHLBI NIH HHS R01 HL034594NHLBI NIH HHS R01 HL034595NHLBI NIH HHS R01 HL035464NHLBI NIH HHS R01 HL043851NHLBI NIH HHS R01 HL046959NHLBI NIH HHS R01 HL068070NHLBI NIH HHS R01 HL080467NHLBI NIH HHS R01 HL091069NHLBI NIH HHS R56 HL134810NHLBI NIH HHS RC1 HL099355
6 · The paper itself

Abstract

backgroundThe majority of sudden cardiac deaths (SCDs) occur in low-risk populations often as the first manifestation of cardiovascular disease (CVD). Biomarkers are screening tools that may identify subclinical cardiovascular disease and those at elevated risk for SCD. We aimed to determine whether the total to high-density lipoprotein cholesterol ratio, high-sensitivity cardiac troponin I, NT-proBNP (N-terminal pro-B-type natriuretic peptide), or high-sensitivity C-reactive protein individually or in combination could identify individuals at higher SCD risk in large, free-living populations with and without cardiovascular disease.

methodsWe performed a nested case-control study within 6 prospective cohort studies using 565 SCD cases matched to 1090 controls (1:2) by age, sex, ethnicity, smoking status, and presence of cardiovascular disease.

resultsThe median study follow-up time until SCD was 11.3 years. When examined as quartiles or continuous variables in conditional logistic regression models, each of the biomarkers was significantly and independently associated with SCD risk after mutually controlling for cardiac risk factors and other biomarkers. The mutually adjusted odds ratios for the top compared with the bottom quartile were 1.90 (95% CI, 1.30-2.76) for total to high-density lipoprotein cholesterol ratio, 2.59 (95% CI, 1.76-3.83) for high-sensitivity cardiac troponin I, 1.65 (95% CI, 1.12-2.44) for NT-proBNP, and 1.65 (95% CI, 1.13-2.41) for high-sensitivity C-reactive protein. A biomarker score that awarded 1 point when the concentration of any of those 4 biomarkers was in the top quartile (score range, 0-4) was strongly associated with SCD, with an adjusted odds ratio of 1.56 (95% CI, 1.37-1.77) per 1-unit increase in the score.

conclusionsWidely available measures of lipids, subclinical myocardial injury, myocardial strain, and vascular inflammation show significant independent associations with SCD risk in apparently low-risk populations. In combination, these measures may have utility to identify individuals at risk for SCD.

Indexed as

Death, Sudden, CardiacHeart InjuriesAgedBiomarkersCholesterol, HDLC-Reactive ProteinFemaleHumansInflammationMaleMiddle AgedMyocardiumNatriuretic Peptide, BrainPeptide FragmentsProspective StudiesTroponin IBiomarkersCholesterol, HDLC-Reactive ProteinNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Troponin Icholesteroldeath, suddeninflammationlipidspro-brain natriuretic peptide (1-76)troponin

Identifiers

PMID32700639
PMCPMC7995996
OpenAlexW3043911155

What Socratic holds

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Registered trials

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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.