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Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease : A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial

Winkel, Per (author)
The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Jakobsen, Janus Christian (author)
The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Regional Health Research, The Faculty of Heath Sciences, University of Southern Denmark, Copenhagen, Denmark
Hilden, Jørgen (author)
Section of Biostatistics, Department of Public Health Research, University of Copenhagen, Copenhagen, Denmark
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Jensen, Gorm Boje (author)
Department of Cardiology, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
Kjøller, Erik (author)
Cardiology, Herlev and Gentofte Hospital, Herlev, Denmark
Sajadieh, Ahmad (author)
Department of Cardiology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
Kastrup, Jens (author)
Rigshopitalet, University of Copenhagen, Copenhagen, Denmark
Kolmos, Hans Jørn (author)
Department of Clinical Microbiology, Odense University Hospital, Copenhagen, Denmark
Karmark Iversen, Kasper (author)
Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
Bjerre, Mette (author)
The Medical Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
Larsson, Anders (author)
Uppsala universitet,Klinisk kemi
Ärnlöv, Johan (author)
Karolinska Institutet
Gluud, Christian (author)
The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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 (creator_code:org_t)
2020-08-20
2020
English.
In: BMJ Open. - : BMJ. - 2044-6055. ; 10:8
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • OBJECTIVE: To assess if 12 novel circulating biomarkers, when added to 'standard predictors' available in general practice, could improve the 10-year prediction of cardiovascular events and mortality in patients with stable coronary heart disease.DESIGN: The patients participated as placebo receiving patients in the randomised clarithromycin for patients with stable coronary artery disease (CLARICOR) trial at a random time in their disease trajectory.SETTING: Five Copenhagen University cardiology departments and a coordinating centre.PARTICIPANTS: 1998 participants with stable coronary artery disease.OUTCOMES: Death and composite of myocardial infarction, unstable angina pectoris, cerebrovascular disease and death.RESULTS: When only 'standard predictors' were included, 83.4% of all-cause death predictions and 68.4% of composite outcome predictions were correct. Log(calprotectin) and log(cathepsin-S) were not associated (p≥0.01) with the outcomes, not even as single predictors. Adding the remaining 10 biomarkers (high-sensitive assay cardiac troponin T; neutrophil gelatinase-associated lipocalin; osteoprotegerin; N-terminal pro-B-type natriuretic peptide; tumour necrosis factor receptor 1 and 2; pregnancy-associated plasma protein A; endostatin; YKL40; cathepsin-B), which were all individually significantly associated with the prediction of the two outcomes, increased the figures to 84.7% and 69.7%.CONCLUSION: When 'standard predictors' routinely available in general practices are used for risk assessment in consecutively sampled patients with stable coronary artery disease, the addition of 10 novel biomarkers to the prediction model improved the correct prediction of all-cause death and the composite outcome by <1.5%.TRIAL REGISTRATION NUMBER: NCT00121550.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

biomarker
cardiology
coronary heart disease

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art (subject category)

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