C-reactive protein for predicting cardiovascular and all-cause mortality in type 2 diabetic patients: A meta-analysis

Abstract

Aims: There is interest in using blood C-reactive protein (CRP) to predict adverse prognosis outcomes patients with type 2 diabetes. This meta-analysis aimed to investigate the association between elevated baseline CRP level and unfavorable outcomes in type 2 diabetes patients.

Materials/methods: PubMed and Embase databases were systematically searched for studies on the association of elevated baseline CRP level with cardiovascular mortality and all-cause mortality from their inception to July 2018. Pooled risk ratio (RR) with 95% confidence intervals (CI) was calculated for the highest versus the lowest CRP level.

Results: Six prospective cohort studies and two post hoc analyses of randomized controlled trials involving 22,322 type 2 diabetes patients were included. Meta-analysis indicated that type 2 diabetes patients with the highest CRP level had a greater risk of all-cause mortality (RR 2.03; 95% CI 1.49-2.75) and cardiovascular mortality (RR 1.76; 95% CI 1.46-2.13). Subgroups analysis indicated that the increased cardiovascular and all-cause mortality risk was consistently found in different study design, follow-up duration or patients with or without cardiovascular risk/established cardiovascular disease subgroups.

Conclusions: This meta-analysis indicates that elevated baseline serum CRP level is independently associated with future cardiovascular and all-cause mortality in type 2 diabetes patients.

Keywords: All-cause mortality; C-reactive protein; Cardiovascular mortality; Meta-analysis; Type 2 diabetes.