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Pregnancy Associated Plasma Protein-A as a Cardiovascular Risk Marker in Patients with Stable Coronary Heart Disease During 10 Years Follow-Up-A CLARICOR Trial Sub-Study

Nilsson, Erik, 1975- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,School of Medical Sciences, Örebro University, 70182 Örebro, Sweden.
Kastrup, Jens (författare)
Department of Cardiology, Rigshospitalet University of Copenhagen, 2100 Copenhagen, Denmark.
Sajadieh, Ahmad (författare)
Department of Cardiology, Copenhagen University Hospital of Bispebjerg and Frederiksberg, 2000 Frederiksberg, Denmark.
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Jensen, Gorm Boje (författare)
Department of Cardiology, Hvidovre Hospital University of Copenhagen, 2650 Hvidovre, Denmark.
Kjøller, Erik (författare)
Department of Cardiology S, Herlev Hospital University of Copenhagen, Herlev, Denmark; Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark,Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark.
Kolmos, Hans Jørn (författare)
Department of Clinical Microbiology, Odense University Hospital, 5000 Odense, Denmark.
Wuopio, Jonas (författare)
Department of Medicine, Mora County Hospital, 79251 Mora, Sweden.
Nowak, Christoph (författare)
Karolinska Institutet
Larsson, Anders (författare)
Karolinska Institutet,Uppsala universitet,Klinisk kemi
Jakobsen, Janus Christian (författare)
Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Cardiology, Holbæk Hospital, Holbæk, Denmark,Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark.
Winkel, Per (författare)
Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark.
Gluud, Christian (författare)
Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark.
Iversen, Kasper K. (författare)
Department of Cardiology S, Herlev Hospital University of Copenhagen, 2730 Herlev, Denmark.
Ärnlöv, Johan, 1970- (författare)
Karolinska Institutet,Högskolan Dalarna,Medicinsk vetenskap,Division for Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183 Huddinge, Sweden.
Carlsson, Axel C. (författare)
Division for Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183 Huddinge, Sweden.
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 (creator_code:org_t)
2020-01-18
2020
Engelska.
Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 9:1
Relaterad länk:
https://doi.org/10.3...
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https://www.mdpi.com...
https://du.diva-port... (primary) (Raw object)
https://uu.diva-port... (primary) (Raw object)
https://urn.kb.se/re...
https://doi.org/10.3...
https://urn.kb.se/re...
https://urn.kb.se/re...
http://kipublication...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Elevated pregnancy-associated plasma protein A (PAPP-A) is associated with mortality in acute coronary syndromes. Few studies have assessed PAPP-A in stable coronary artery disease (CAD) and results are conflicting. We assessed the 10-year prognostic relevance of PAPP-A levels in stable CAD. The CLARICOR trial was a randomized controlled clinical trial including outpatients with stable CAD, randomized to clarithromycin versus placebo. The placebo group constituted our discovery cohort (n = 1.996) and the clarithromycin group the replication cohort (n = 1.975). The composite primary outcome was first occurrence of cardiovascular event or death. In the discovery cohort, incidence rates (IR) for the composite outcome were higher in those with elevated PAPP-A (IR 12.72, 95% Confidence Interval (CI) 11.0-14.7 events/100 years) compared to lower PAPP-A (IR 8.78, 8.25-9.34), with comparable results in the replication cohort. Elevated PAPP-A was associated with increased risk of the composite outcome in both cohorts (discovery Hazard Ratio (HR) 1.45, 95% CI 1.24-1.70; replication HR 1.29, 95% CI 1.10-1.52). In models adjusted for established risk factors, these trends were attenuated. Elevated PAPP-A was associated with higher all-cause mortality in both cohorts. We conclude that elevated PAPP-A levels are associated with increased long-term mortality in stable CAD, but do not improve long-term prediction of death or cardiovascular events when added to established predictors.

Ämnesord

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

Nyckelord

pregnancy-associated plasma protein-A
coronary artery disease
cohort studies
biomarkers
Health and Welfare

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