Sex- and age-related differences in the predictive capability of circulating biomarkers: from the MONICA 10 cohort

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Charles E. Frary
  • Biering-Sørensen, Tor
  • Kotaro Nochioka
  • Marie K. Blicher
  • Thomas B. Olesen
  • Jacob V. Stidsen
  • Sara V. Greve
  • Julie K.K. Vishram-Nielsen
  • Susanne L. Rasmussen
  • Jesper Eugen-Olsen
  • Michael H. Olsen
  • Manan Pareek

Objectives: The purpose of this study was to assess whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) differed in their ability to predict cardiovascular outcomes beyond traditional risk factors in younger and older men and women without known cardiovascular disease. Design. Prospective population-based cohort study of 1951 individuals from the MONItoring of trends and determinants in Cardiovascular disease (MONICA) study, examined 1993–1994. Participants were stratified into four groups based on sex and age. Subjects aged 41 or 51 years were classified as younger; those aged 61 or 71 years were classified as older. The principal endpoint was death from cardiovascular causes. Predictive capabilities of biomarkers were tested using Cox proportional-hazards regression, Harrell’s concordance-index, net reclassification improvement, and classification and regression tree (CART) analysis. Results. Median follow-up was 18.5 years, during which 19/597 younger men, 100/380 older men, 12/607 younger women, and 46/367 older women had died from a cardiovascular cause. NT-proBNP was independently associated with death from cardiovascular causes among all participants (p ≤.02) except younger women (p =.70), whereas hs-CRP was associated with this endpoint in men (p ≤.007), and suPAR in older men only (p <.001). None of the biomarkers improved discrimination ability beyond traditional risk factors (p ≥.07). However, NT-proBNP enhanced reclassification in men and older women. CART-analysis showed that NT-proBNP was generally of greater value among men, and suPAR among women. Conclusions. Hs-CRP, NT-proBNP, and suPAR displayed different associations with cardiovascular death among apparently healthy younger and older men and women.

OriginalsprogEngelsk
TidsskriftScandinavian Cardiovascular Journal
Vol/bind55
Udgave nummer2
Sider (fra-til)65-72
Antal sider8
ISSN1401-7431
DOI
StatusUdgivet - 2021
Eksternt udgivetJa

Bibliografisk note

Funding Information:
Dr. Tor Biering-Sørensen discloses the following relationships – Steering Committee member of the Amgen financed GALACTIC-HF trial; Advisory Board: Sanofi Pasteur, Amgen; Speaker Honorarium: Novartis, Sanofi Pasteur. Dr. Michael Hecht Olsen discloses that he has received a part-time clinical research grant from the Novo Nordisk Foundation. Dr. Manan Pareek discloses the following relationships – Advisory Board: AstraZeneca and Janssen-Cilag; Speaker’s Fee: AstraZeneca, Bayer, Boehringer Ingelheim, and Janssen-Cilag. The remaining authors have no disclosures to report.

Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.

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