Single and multiple cardiovascular biomarkers in subjects without a previous cardiovascular event
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Single and multiple cardiovascular biomarkers in subjects without a previous cardiovascular event. / Pareek, Manan; Bhatt, Deepak L.; Vaduganathan, Muthiah; Biering-Sørensen, Tor; Qamar, Arman; Diederichsen, Axel C.P.; Møller, Jacob Eifer; Hindersson, Peter; Leósdóttir, Margrét; Magnusson, Martin; Nilsson, Peter M.; Olsen, Michael H.
I: European Journal of Preventive Cardiology, Bind 24, Nr. 15, 2017, s. 1648-1659.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Single and multiple cardiovascular biomarkers in subjects without a previous cardiovascular event
AU - Pareek, Manan
AU - Bhatt, Deepak L.
AU - Vaduganathan, Muthiah
AU - Biering-Sørensen, Tor
AU - Qamar, Arman
AU - Diederichsen, Axel C.P.
AU - Møller, Jacob Eifer
AU - Hindersson, Peter
AU - Leósdóttir, Margrét
AU - Magnusson, Martin
AU - Nilsson, Peter M.
AU - Olsen, Michael H.
N1 - Publisher Copyright: © European Society of Cardiology.
PY - 2017
Y1 - 2017
N2 - Aims To assess the incremental value of biomarkers, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hs-TnT), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), growth differentiation factor 15 (GDF-15), and procollagen type 1 N-terminal propeptide (P1NP), in predicting incident cardiovascular events and mortality among asymptomatic individuals from the general population, beyond traditional risk factors, including fasting glucose and renal function (cystatin C), medication use, and echocardiographic measures. Methods and results Prospective population-based cohort study of 1324 subjects without a previous cardiovascular event, who underwent baseline echocardiography and biomarker assessment between 2002 and 2006. The clinical endpoint was the composite of myocardial infarction, invasively treated stable/unstable ischemic heart disease, heart failure, stroke, or all-cause mortality. Predictive capabilities were evaluated using Cox proportional-hazards regression, Harrell's concordance index (C-index), and net reclassification improvement. Median age was 66 (interquartile range: 60-70) years, and 413 (31%) were female. During median 8.6 (interquartile range: 8.1-9.2) follow-up years, 368 (28%) composite events occurred. NT-proBNP, hs-TnT, GDF-15, and IL-6 were significantly associated with outcome, independently of traditional risk factors, medications, and echocardiography (p < 0.05 for all). Separate addition of NT-proBNP and GDF-15 to traditional risk factors, medications, and echocardiographic measurements provided significant improvements in discriminative ability (NT-proBNP: C-index 0.714 vs. 0.703, p = 0.03; GDF-15: C-index 0.721 vs. 0.703, p = 0.02). Both biomarkers remained significant predictors of outcome upon inclusion in the same model (p < 0.05 for both). Conclusions NT-proBNP and GDF-15 each enhance prognostication beyond traditional risk factors, glucose levels, renal function, and echocardiography in individuals without known cardiovascular disease.
AB - Aims To assess the incremental value of biomarkers, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hs-TnT), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), growth differentiation factor 15 (GDF-15), and procollagen type 1 N-terminal propeptide (P1NP), in predicting incident cardiovascular events and mortality among asymptomatic individuals from the general population, beyond traditional risk factors, including fasting glucose and renal function (cystatin C), medication use, and echocardiographic measures. Methods and results Prospective population-based cohort study of 1324 subjects without a previous cardiovascular event, who underwent baseline echocardiography and biomarker assessment between 2002 and 2006. The clinical endpoint was the composite of myocardial infarction, invasively treated stable/unstable ischemic heart disease, heart failure, stroke, or all-cause mortality. Predictive capabilities were evaluated using Cox proportional-hazards regression, Harrell's concordance index (C-index), and net reclassification improvement. Median age was 66 (interquartile range: 60-70) years, and 413 (31%) were female. During median 8.6 (interquartile range: 8.1-9.2) follow-up years, 368 (28%) composite events occurred. NT-proBNP, hs-TnT, GDF-15, and IL-6 were significantly associated with outcome, independently of traditional risk factors, medications, and echocardiography (p < 0.05 for all). Separate addition of NT-proBNP and GDF-15 to traditional risk factors, medications, and echocardiographic measurements provided significant improvements in discriminative ability (NT-proBNP: C-index 0.714 vs. 0.703, p = 0.03; GDF-15: C-index 0.721 vs. 0.703, p = 0.02). Both biomarkers remained significant predictors of outcome upon inclusion in the same model (p < 0.05 for both). Conclusions NT-proBNP and GDF-15 each enhance prognostication beyond traditional risk factors, glucose levels, renal function, and echocardiography in individuals without known cardiovascular disease.
KW - Biomarkers
KW - discrimination
KW - echocardiography
KW - prognosis
KW - reclassification
UR - http://www.scopus.com/inward/record.url?scp=85030683156&partnerID=8YFLogxK
U2 - 10.1177/2047487317717065
DO - 10.1177/2047487317717065
M3 - Journal article
C2 - 28644092
AN - SCOPUS:85030683156
VL - 24
SP - 1648
EP - 1659
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
SN - 2047-4873
IS - 15
ER -
ID: 322954766