Evidence map›Paper›PMID 41160314›Full record

Trial reportGeroScience2026

Elevated alpha-1 antitrypsin and C-reactive protein: association on all-cause and cause-specific mortality in older adults.

Cammie Tran, Hans G Schneider, Que T Lam, Johannes T Neumann, Flavia Cicuttini, Chenglong Yu, Zhen Zhou, Mark R Nelson, Andrew M Tonkin, Daniel Clayton-Chubb and 6 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in GeroScience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

16 authors.

Cammie TranSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia. Cammie.tran@monash.edu.ORCID http://orcid.org/0000-0003-3997-6118
Hans G SchneiderSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Que T LamClinical Biochemistry Unit, Alfred Health, Melbourne, VIC, Australia.
Johannes T NeumannSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Flavia CicuttiniSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Chenglong YuSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Zhen ZhouSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Mark R NelsonMenzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Andrew M TonkinSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Daniel Clayton-ChubbSchool of Translational Medicine, Monash University, Melbourne, Australia.
Sultana Monira HussainSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Peter D FransquetSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Robyn L WoodsSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Suzanne G OrchardSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Paul LacazeSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
John J McNeilSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.

Funding

ASPirin in Reducing Events in the ElderlyU01AG029824 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI MCNEIL, JOHN JAMES, MURRAY, ANNE M · 2009 to 2018
$64.6M
Main Administrative CoreU19AG062682 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI CHAN, ANDREW T, MCNEIL, JOHN JAMES · 2019 to 2023
$42.9M
Deutsche Forschungsgemeinschaft 525678868National Health and Medical Research Council 1127060National Health and Medical Research Council 2026325National Health and Medical Research Council 334047National Health and Medical Research Council IG1173690National Heart Foundation of Australia 102604National Heart Foundation of Australia 108071-2002_VGNIA NIH HHS U01 AG029824NIA NIH HHS U19 AG062682NIH HHS U01AG029824NIH HHS U01AG029824-02NIH HHS U19AG062682
6 · The paper itself

Abstract

Alpha-1 antitrypsin (AAT) deficiency in younger people is well characterized, but the effects of elevated AAT levels in older age are unclear. We examined the effect of elevated AAT levels and mortality in a longitudinal cohort of older adults, alongside high-sensitivity C-reactive protein (hs-CRP) levels. This post hoc analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) trial included 11,879 adults aged ≥ 70 years without prior cardiovascular disease, dementia or life-limiting illness at enrolment. Cox proportional hazard models estimated adjusted hazard ratios (aHRs) for all-cause and cause-specific mortality (cancer, cardiovascular and other) over a median follow-up of 10.9 years. AAT and hs-CRP were analyzed in deciles, comparing the highest decile to the middle 80% as reference. Median (IQR) levels of AAT and hs-CRP in the top decile were 1.69 (1.65-1.78) g/L and 10.40 (7.97-15.53) mg/L, respectively. Individuals in highest AAT decile had a 53% higher likelihood of mortality during follow-up (aHR 1.53, 95% CI 1.28-1.65). Risk of cancer, cardiovascular and 'other' deaths were all elevated. The associations remained significant after excluding participants with elevated hs-CRP. Participants in the highest hs-CRP decile had a 32% higher likelihood of mortality (aHR 1.32, 95% CI 1.18-1.48). Elevated hs-CRP was associated with cancer and 'other' mortality but not cardiovascular mortality. Elevated AAT is a robust predictor of mortality in older adults, independent of hs-CRP, and may reflect subtle, age-related changes in systemic inflammation. These findings support the potential utility of AAT as a biomarker of biological ageing and mortality risk.

Indexed as

alpha 1-AntitrypsinCardiovascular DiseasesC-Reactive ProteinNeoplasmsAgedAged, 80 and overBiomarkersCause of DeathFemaleHumansLongitudinal StudiesMaleProportional Hazards Modelsalpha 1-AntitrypsinBiomarkersC-Reactive ProteinAlpha-1 AntitrypsinInflammationMortality

Identifiers

PMID41160314
PMCPMC13575080

What Socratic holds

Textmetadata
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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.