Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort
Aims The aim of this study was to examine whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) carried incremental prognostic value in predicting cardiovascular morbidity and mortality...
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| Veröffentlicht in: | European journal of preventive cardiology 2020-04, Vol.27 (6), p.570-578 |
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| container_title | European journal of preventive cardiology |
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| creator | Frary, Charles Edward Blicher, Marie Kofoed Olesen, Thomas Bastholm Stidsen, Jacob Volmer Greve, Sara Vikström Vishram-Nielsen, Julie KK Rasmussen, Susanne Lone Olsen, Michael Hecht Pareek, Manan |
| description | Aims
The aim of this study was to examine whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) carried incremental prognostic value in predicting cardiovascular morbidity and mortality beyond traditional risk factors in apparently healthy individuals.
Methods and results
This was a prospective population-based cohort study comprising 1951 subjects included in the 10-year follow-up of the MONItoring of trends and determinants in CArdiovascular disease (MONICA) study, between 1993 and 1994. The principal endpoint was death from cardiovascular causes. Secondary endpoints were death from any cause, coronary artery disease, heart failure, and cerebrovascular disease. Predictive capabilities of each of the three biomarkers were tested using Cox proportional-hazards regression, Harrell’s concordance index (C-index), and net reclassification improvement (NRI). Study participants were aged 41, 51, 61, or 71 years, and equally distributed between the two sexes. During a median follow-up of 18.5 years (interquartile range: 18.1–19.0), 177 (9.1%) subjects died from a cardiovascular cause. Hs-CRP (adjusted standardized hazard ratio (HR): 1.37, 95% confidence interval (CI): 1.17–1.60), NT-proBNP (HR: 1.90, 95% CI: 1.58–2.29), and suPAR (HR: 1.35, 95% CI: 1.17–1.57) were all significantly associated with cardiovascular deaths after adjustment for age, sex, smoking status, systolic blood pressure, and total cholesterol (p |
| doi_str_mv | 10.1177/2047487319885457 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2314248168</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2047487319885457</sage_id><sourcerecordid>2314248168</sourcerecordid><originalsourceid>FETCH-LOGICAL-c337t-be3b2e7e80735065214683b03323fe31450a375d162eaef3550bda92dfcc43ab3</originalsourceid><addsrcrecordid>eNp1kDtPwzAURi0EAlTYmZBHloAfcW1GVPGSCiwwR45z0xqSuFw7SJ3547gqMCDhwbauznek-xFywtk551pfCFbq0mjJL41RpdI75HAzKkpj-O7vX8sDchzjK8tnyoQwZp8cSK65EUofks-ZRzd2NvlhQWsfeotvgJG2AWkXhkWRAHvqLDY-fNi4QZGij280Jsyp1rt8h4H6gdrVyiIMqVvTJdguLdd52vgP34y2y0oMPU1LoA9Pj_ezK8oZdWEZMB2RvTYDcPz9TsjLzfXz7K6YP91mcF44KXUqapC1AA2GaanYVAleTo2smZRCtiB5qZiVWjV8KsBCK5VidWMvRdM6V0pbywk523pXGN5HiKnqfXTQdXaAMMZKZIcoDc_WCWFb1GGIEaGtVuhzN-uKs2rTfvW3_Rw5_baPdQ_Nb-Cn6wwUWyDaBVSvYcQhb_u_8Av1HY3G</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2314248168</pqid></control><display><type>article</type><title>Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort</title><source>MEDLINE</source><source>SAGE Complete A-Z List</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Frary, Charles Edward ; Blicher, Marie Kofoed ; Olesen, Thomas Bastholm ; Stidsen, Jacob Volmer ; Greve, Sara Vikström ; Vishram-Nielsen, Julie KK ; Rasmussen, Susanne Lone ; Olsen, Michael Hecht ; Pareek, Manan</creator><creatorcontrib>Frary, Charles Edward ; Blicher, Marie Kofoed ; Olesen, Thomas Bastholm ; Stidsen, Jacob Volmer ; Greve, Sara Vikström ; Vishram-Nielsen, Julie KK ; Rasmussen, Susanne Lone ; Olsen, Michael Hecht ; Pareek, Manan</creatorcontrib><description>Aims
The aim of this study was to examine whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) carried incremental prognostic value in predicting cardiovascular morbidity and mortality beyond traditional risk factors in apparently healthy individuals.
Methods and results
This was a prospective population-based cohort study comprising 1951 subjects included in the 10-year follow-up of the MONItoring of trends and determinants in CArdiovascular disease (MONICA) study, between 1993 and 1994. The principal endpoint was death from cardiovascular causes. Secondary endpoints were death from any cause, coronary artery disease, heart failure, and cerebrovascular disease. Predictive capabilities of each of the three biomarkers were tested using Cox proportional-hazards regression, Harrell’s concordance index (C-index), and net reclassification improvement (NRI). Study participants were aged 41, 51, 61, or 71 years, and equally distributed between the two sexes. During a median follow-up of 18.5 years (interquartile range: 18.1–19.0), 177 (9.1%) subjects died from a cardiovascular cause. Hs-CRP (adjusted standardized hazard ratio (HR): 1.37, 95% confidence interval (CI): 1.17–1.60), NT-proBNP (HR: 1.90, 95% CI: 1.58–2.29), and suPAR (HR: 1.35, 95% CI: 1.17–1.57) were all significantly associated with cardiovascular deaths after adjustment for age, sex, smoking status, systolic blood pressure, and total cholesterol (p < 0.001 for all). Furthermore, all three biomarkers were significantly associated with significant NRI. However, only NT-proBNP significantly raised the C-index in predicting death from cardiovascular causes when added to the risk factors (C-index 0.860 versus 0.847; p = 0.02).
Conclusions
Hs-CRP, suPAR, and particularly NT-proBNP predicted cardiovascular death and may enhance prognostication beyond traditional risk factors in apparently healthy individuals.</description><identifier>ISSN: 2047-4873</identifier><identifier>EISSN: 2047-4881</identifier><identifier>DOI: 10.1177/2047487319885457</identifier><identifier>PMID: 31718257</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Aged ; Biomarkers - blood ; C-Reactive Protein - analysis ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - mortality ; Denmark - epidemiology ; Female ; Heart Disease Risk Factors ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Predictive Value of Tests ; Prognosis ; Receptors, Urokinase Plasminogen Activator - blood ; Risk Assessment ; Time Factors</subject><ispartof>European journal of preventive cardiology, 2020-04, Vol.27 (6), p.570-578</ispartof><rights>The European Society of Cardiology 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-be3b2e7e80735065214683b03323fe31450a375d162eaef3550bda92dfcc43ab3</citedby><cites>FETCH-LOGICAL-c337t-be3b2e7e80735065214683b03323fe31450a375d162eaef3550bda92dfcc43ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/2047487319885457$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/2047487319885457$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31718257$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Frary, Charles Edward</creatorcontrib><creatorcontrib>Blicher, Marie Kofoed</creatorcontrib><creatorcontrib>Olesen, Thomas Bastholm</creatorcontrib><creatorcontrib>Stidsen, Jacob Volmer</creatorcontrib><creatorcontrib>Greve, Sara Vikström</creatorcontrib><creatorcontrib>Vishram-Nielsen, Julie KK</creatorcontrib><creatorcontrib>Rasmussen, Susanne Lone</creatorcontrib><creatorcontrib>Olsen, Michael Hecht</creatorcontrib><creatorcontrib>Pareek, Manan</creatorcontrib><title>Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort</title><title>European journal of preventive cardiology</title><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><description>Aims
The aim of this study was to examine whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) carried incremental prognostic value in predicting cardiovascular morbidity and mortality beyond traditional risk factors in apparently healthy individuals.
Methods and results
This was a prospective population-based cohort study comprising 1951 subjects included in the 10-year follow-up of the MONItoring of trends and determinants in CArdiovascular disease (MONICA) study, between 1993 and 1994. The principal endpoint was death from cardiovascular causes. Secondary endpoints were death from any cause, coronary artery disease, heart failure, and cerebrovascular disease. Predictive capabilities of each of the three biomarkers were tested using Cox proportional-hazards regression, Harrell’s concordance index (C-index), and net reclassification improvement (NRI). Study participants were aged 41, 51, 61, or 71 years, and equally distributed between the two sexes. During a median follow-up of 18.5 years (interquartile range: 18.1–19.0), 177 (9.1%) subjects died from a cardiovascular cause. Hs-CRP (adjusted standardized hazard ratio (HR): 1.37, 95% confidence interval (CI): 1.17–1.60), NT-proBNP (HR: 1.90, 95% CI: 1.58–2.29), and suPAR (HR: 1.35, 95% CI: 1.17–1.57) were all significantly associated with cardiovascular deaths after adjustment for age, sex, smoking status, systolic blood pressure, and total cholesterol (p < 0.001 for all). Furthermore, all three biomarkers were significantly associated with significant NRI. However, only NT-proBNP significantly raised the C-index in predicting death from cardiovascular causes when added to the risk factors (C-index 0.860 versus 0.847; p = 0.02).
Conclusions
Hs-CRP, suPAR, and particularly NT-proBNP predicted cardiovascular death and may enhance prognostication beyond traditional risk factors in apparently healthy individuals.</description><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>C-Reactive Protein - analysis</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Denmark - epidemiology</subject><subject>Female</subject><subject>Heart Disease Risk Factors</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptide Fragments - blood</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Receptors, Urokinase Plasminogen Activator - blood</subject><subject>Risk Assessment</subject><subject>Time Factors</subject><issn>2047-4873</issn><issn>2047-4881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDtPwzAURi0EAlTYmZBHloAfcW1GVPGSCiwwR45z0xqSuFw7SJ3547gqMCDhwbauznek-xFywtk551pfCFbq0mjJL41RpdI75HAzKkpj-O7vX8sDchzjK8tnyoQwZp8cSK65EUofks-ZRzd2NvlhQWsfeotvgJG2AWkXhkWRAHvqLDY-fNi4QZGij280Jsyp1rt8h4H6gdrVyiIMqVvTJdguLdd52vgP34y2y0oMPU1LoA9Pj_ezK8oZdWEZMB2RvTYDcPz9TsjLzfXz7K6YP91mcF44KXUqapC1AA2GaanYVAleTo2smZRCtiB5qZiVWjV8KsBCK5VidWMvRdM6V0pbywk523pXGN5HiKnqfXTQdXaAMMZKZIcoDc_WCWFb1GGIEaGtVuhzN-uKs2rTfvW3_Rw5_baPdQ_Nb-Cn6wwUWyDaBVSvYcQhb_u_8Av1HY3G</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Frary, Charles Edward</creator><creator>Blicher, Marie Kofoed</creator><creator>Olesen, Thomas Bastholm</creator><creator>Stidsen, Jacob Volmer</creator><creator>Greve, Sara Vikström</creator><creator>Vishram-Nielsen, Julie KK</creator><creator>Rasmussen, Susanne Lone</creator><creator>Olsen, Michael Hecht</creator><creator>Pareek, Manan</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202004</creationdate><title>Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort</title><author>Frary, Charles Edward ; Blicher, Marie Kofoed ; Olesen, Thomas Bastholm ; Stidsen, Jacob Volmer ; Greve, Sara Vikström ; Vishram-Nielsen, Julie KK ; Rasmussen, Susanne Lone ; Olsen, Michael Hecht ; Pareek, Manan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-be3b2e7e80735065214683b03323fe31450a375d162eaef3550bda92dfcc43ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>C-Reactive Protein - analysis</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Denmark - epidemiology</topic><topic>Female</topic><topic>Heart Disease Risk Factors</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptide Fragments - blood</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Receptors, Urokinase Plasminogen Activator - blood</topic><topic>Risk Assessment</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Frary, Charles Edward</creatorcontrib><creatorcontrib>Blicher, Marie Kofoed</creatorcontrib><creatorcontrib>Olesen, Thomas Bastholm</creatorcontrib><creatorcontrib>Stidsen, Jacob Volmer</creatorcontrib><creatorcontrib>Greve, Sara Vikström</creatorcontrib><creatorcontrib>Vishram-Nielsen, Julie KK</creatorcontrib><creatorcontrib>Rasmussen, Susanne Lone</creatorcontrib><creatorcontrib>Olsen, Michael Hecht</creatorcontrib><creatorcontrib>Pareek, Manan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of preventive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Frary, Charles Edward</au><au>Blicher, Marie Kofoed</au><au>Olesen, Thomas Bastholm</au><au>Stidsen, Jacob Volmer</au><au>Greve, Sara Vikström</au><au>Vishram-Nielsen, Julie KK</au><au>Rasmussen, Susanne Lone</au><au>Olsen, Michael Hecht</au><au>Pareek, Manan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort</atitle><jtitle>European journal of preventive cardiology</jtitle><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><date>2020-04</date><risdate>2020</risdate><volume>27</volume><issue>6</issue><spage>570</spage><epage>578</epage><pages>570-578</pages><issn>2047-4873</issn><eissn>2047-4881</eissn><abstract>Aims
The aim of this study was to examine whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) carried incremental prognostic value in predicting cardiovascular morbidity and mortality beyond traditional risk factors in apparently healthy individuals.
Methods and results
This was a prospective population-based cohort study comprising 1951 subjects included in the 10-year follow-up of the MONItoring of trends and determinants in CArdiovascular disease (MONICA) study, between 1993 and 1994. The principal endpoint was death from cardiovascular causes. Secondary endpoints were death from any cause, coronary artery disease, heart failure, and cerebrovascular disease. Predictive capabilities of each of the three biomarkers were tested using Cox proportional-hazards regression, Harrell’s concordance index (C-index), and net reclassification improvement (NRI). Study participants were aged 41, 51, 61, or 71 years, and equally distributed between the two sexes. During a median follow-up of 18.5 years (interquartile range: 18.1–19.0), 177 (9.1%) subjects died from a cardiovascular cause. Hs-CRP (adjusted standardized hazard ratio (HR): 1.37, 95% confidence interval (CI): 1.17–1.60), NT-proBNP (HR: 1.90, 95% CI: 1.58–2.29), and suPAR (HR: 1.35, 95% CI: 1.17–1.57) were all significantly associated with cardiovascular deaths after adjustment for age, sex, smoking status, systolic blood pressure, and total cholesterol (p < 0.001 for all). Furthermore, all three biomarkers were significantly associated with significant NRI. However, only NT-proBNP significantly raised the C-index in predicting death from cardiovascular causes when added to the risk factors (C-index 0.860 versus 0.847; p = 0.02).
Conclusions
Hs-CRP, suPAR, and particularly NT-proBNP predicted cardiovascular death and may enhance prognostication beyond traditional risk factors in apparently healthy individuals.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>31718257</pmid><doi>10.1177/2047487319885457</doi><tpages>9</tpages></addata></record> |
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| ispartof | European journal of preventive cardiology, 2020-04, Vol.27 (6), p.570-578 |
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| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Aged Biomarkers - blood C-Reactive Protein - analysis Cardiovascular Diseases - blood Cardiovascular Diseases - diagnosis Cardiovascular Diseases - mortality Denmark - epidemiology Female Heart Disease Risk Factors Humans Male Middle Aged Natriuretic Peptide, Brain - blood Peptide Fragments - blood Predictive Value of Tests Prognosis Receptors, Urokinase Plasminogen Activator - blood Risk Assessment Time Factors |
| title | Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort |
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