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Biomarker-based pre...
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Haller, Paul M.Department for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistrasse 52, Hamburg, Germany
(author)
Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus
- Article/chapterEnglish2023
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LIBRIS-ID:oai:DiVA.org:umu-214279
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-214279URI
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https://doi.org/10.1093/eurjpc/zwad122DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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AIMS: The role of biomarkers in predicting cardiovascular outcomes in high-risk individuals is not well established. We aimed to investigate benefits of adding biomarkers to cardiovascular risk assessment in individuals with and without diabetes. 'METHODS AND RESULTS: We used individual-level data of 95 292 individuals of the European population harmonized in the Biomarker for Cardiovascular Risk Assessment across Europe consortium and investigated the prognostic ability of high-sensitivity cardiac troponin I (hs-cTnI), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP). Cox-regression models were used to determine adjusted hazard ratios of diabetes and log-transformed biomarkers for fatal and non-fatal cardiovascular events. Models were compared using the likelihood ratio test. Stratification by specific biomarker cut-offs was performed for crude time-to-event analysis using Kaplan-Meier plots. Overall, 6090 (6.4%) individuals had diabetes at baseline, median follow-up was 9.9 years. Adjusting for classical risk factors and biomarkers, diabetes [HR 2.11 (95% CI 1.92, 2.32)], and all biomarkers (HR per interquartile range hs-cTnI 1.08 [95% CI 1.04, 1.12]; NT-proBNP 1.44 [95% CI 1.37, 1.53]; hs-CRP 1.27 [95% CI 1.21, 1.33]) were independently associated with cardiovascular events. Specific cut-offs for each biomarker identified a high-risk group of individuals with diabetes losing a median of 15.5 years of life compared to diabetics without elevated biomarkers. Addition of biomarkers to the Cox-model significantly improved the prediction of outcomes (likelihood ratio test for nested models P < 0.001), accompanied by an increase in the c-index (increase to 0.81).CONCLUSION: Biomarkers improve cardiovascular risk prediction in individuals with and without diabetes and facilitate the identification of individuals with diabetes at highest risk for cardiovascular events.
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Goßling, AlinaDepartment for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
(author)
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Magnussen, ChristinaDepartment for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistrasse 52, Hamburg, Germany
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Brenner, HermannGerman Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 280, Heidelberg, Germany
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Schöttker, BenGerman Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 280, Heidelberg, Germany
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Iacoviello, Licia1) Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Atinense ,18, Pozzilli, Italy; Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Via O. Rossi 9, Varese, Italy
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Costanzo, Simona1) Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Atinense ,18, Pozzilli, Italy
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Kee, FrankCentre for Public Health, Queens University of Belfast, Belfast, United Kingdom
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Koenig, WolfgangKlinik für Herz-& Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstraße 36, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance ,Lazarettstraße 36, Munich, Germany; Institute of Epidemiology and Medical Biometry, University of Ulm, Helmholtzstr. 22, Ulm, Germany
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Linneberg, AllanCenter for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, Ndr. Fasanvej 57, 1. sal, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark
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Sujana, ChaterinaHelmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology, Ingolstädter Landstraße 1, Germany
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Thorand, BarbaraHelmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology, Ingolstädter Landstraße 1, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, Germany
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Salomaa, VeikkoFinnish Institute for Health and Welfare, Department of Public Health and Welfare, P.O. Box 30, Helsinki, Finland
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Niiranen, Teemu J.Finnish Institute for Health and Welfare, Department of Public Health and Welfare, P.O. Box 30, Helsinki, Finland; Department of Medicine, Turku University Hospital and University of Turku, Kiinamyllynkatu 10, Turku, Finland
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Söderberg, StefanUmeå universitet,Institutionen för folkhälsa och klinisk medicin(Swepub:umu)stso0001
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Völzke, HenryInstitut für Community Medicine, University Medicine Greifswald ,Walter Rathenau Str. 48, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Greifswald ,Walter Rathenau Str. 48, Germany
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Dörr, MarcusGerman Center for Cardiovascular Research (DZHK), Partner Site Greifswald ,Walter Rathenau Str. 48, Germany; Klinik und Poliklinik für Innere Medizin B, University Medicine Greifswald ,Ferdinand-Sauerbruch-Straße, Germany
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Sans, SusanaCatalan Department of Health, Roc Boronat, Barcelona, Spain
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Padró, TeresaInstitut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
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Felix, Stephan B.German Center for Cardiovascular Research (DZHK), Partner Site Greifswald ,Walter Rathenau Str. 48, Germany; Klinik und Poliklinik für Innere Medizin B, University Medicine Greifswald ,Ferdinand-Sauerbruch-Straße, Germany
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Nauck, MatthiasGerman Center for Cardiovascular Research (DZHK), Partner Site Greifswald ,Walter Rathenau Str. 48, Germany; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald ,Ferdinand-Sauerbruch-Straße, Germany
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Petersmann, AstridInstitute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald ,Ferdinand-Sauerbruch-Straße, Germany; University Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Rahel-Straus-Straße 10, Oldenburg, Germany
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Palmieri, LuigiDepartment of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, 299 Viale Regina Elena, Rome, Italy
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Donfrancesco, ChiaraDepartment of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, 299 Viale Regina Elena, Rome, Italy
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De Ponti, RobertoResearch Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Via O. Rossi 9, Varese, Italy
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Veronesi, GiovanniResearch Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Via O. Rossi 9, Varese, Italy
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Ferrario, Marco M.Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Via O. Rossi 9, Varese, Italy
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Kuulasmaa, KariFinnish Institute for Health and Welfare, Department of Public Health and Welfare, P.O. Box 30, Helsinki, Finland
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Zeller, TanjaDepartment for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistrasse 52, Hamburg, Germany
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Ojeda, Francisco M.Department for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
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Blankenberg, StefanDepartment for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistrasse 52, Hamburg, Germany
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Westermann, DirkDepartment of Cardiology and Angiology, University Heart Center Freiburg • Bad Krozingen, Freiburg, Germany
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Department for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Martinistrasse 52, Hamburg, GermanyDepartment for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
(creator_code:org_t)
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In:European Journal of Preventive Cardiology30:12, s. 1218-12262047-48732047-4881
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Haller, Paul M.
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Goßling, Alina
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Magnussen, Chris ...
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Brenner, Hermann
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Schöttker, Ben
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Iacoviello, Lici ...
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Costanzo, Simona
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Kee, Frank
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Koenig, Wolfgang
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Linneberg, Allan
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Sujana, Chaterin ...
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Thorand, Barbara
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Salomaa, Veikko
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Niiranen, Teemu ...
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Söderberg, Stefa ...
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Völzke, Henry
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Dörr, Marcus
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Sans, Susana
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Padró, Teresa
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Felix, Stephan B ...
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Nauck, Matthias
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Petersmann, Astr ...
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Palmieri, Luigi
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Donfrancesco, Ch ...
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De Ponti, Robert ...
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Veronesi, Giovan ...
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Ferrario, Marco ...
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Kuulasmaa, Kari
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Zeller, Tanja
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Ojeda, Francisco ...
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Blankenberg, Ste ...
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Westermann, Dirk
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