The aim of this review was to perform a critical appraisal of serum inflammatory biomarkers used for the prediction of cardiovascular disease (CVD) risk. We conducted a systematic review of studies listed on MEDLINE and Scopus from January 2000 to December 2023, focused on the prognostic value of serum inflammatory biomarkers [i.e., C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)] in individuals without known CVD. Eligible studies used a multivariate prediction model and included discrimination or risk reclassification analysis. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate study quality and potential bias. Thirty-five studies (i.e., total 208,897 participants) that evaluated the added prognostic value of CRP, IL-6, TNF-α on CVD risk prediction were retrieved. Significant improvements in CVD risk model’s predictive ability were observed in 7 out of 32 studies relating CRP and 1 out of 8 studies relating IL-6 with CVD risk. The single study found no added prognostic value of TNF-α use in CVD risk model. The integration of serum inflammatory biomarkers into CVD risk prediction models does not appear to improve risk discrimination models, suggesting that these biomarkers may act as surrogate markers, but not as predictors of atherosclerotic CVD.

中文翻译：

---

用于心血管疾病风险预测模型的血清炎症标志物：系统评价

本综述的目的是对用于预测心血管疾病 (CVD) 风险的血清炎症生物标志物进行严格评估。我们对 2000 年 1 月至 2023 年 12 月期间 MEDLINE 和 Scopus 上列出的研究进行了系统回顾，重点关注血清炎症生物标志物 [即 C 反应蛋白 (CRP)、白细胞介素 - 6 (IL-6) 和肿瘤的预后价值坏死因子-α (TNF-α)] 在没有已知 CVD 的个体中。符合条件的研究使用了多变量预测模型，并包括歧视或风险重新分类分析。预后研究质量 (QUIPS) 工具用于评估研究质量和潜在偏倚。检索了 35 项研究（即总共 208,897 名参与者），评估了 CRP、IL-6、TNF-α 对 CVD 风险预测的附加预后价值。在 32 项有关 CRP 的研究中，有 7 项观察到 CVD 风险模型预测能力的显着改善，在 8 项有关 IL-6 与 CVD 风险的研究中，观察到 1 项显着改善。单项研究发现 TNF-α 在 CVD 风险模型中的使用没有增加预后价值。将血清炎症生物标志物整合到 CVD 风险预测模型中似乎并没有改善风险辨别模型，这表明这些生物标志物可能充当替代标志物，但不能作为动脉粥样硬化 CVD 的预测因子。