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Prognostic value of cardiovascular biomarkers in the population

Neumann, Johannes Tobias (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Twerenbold, Raphael (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
Weimann, Jessica (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ballantyne, Christie M. (författare)
Center for Cardiometabolic Disease Prevention, Department of Medicine, College of Medicine, Baylor University, TX, Houston, United States
Benjamin, Emelia J. (författare)
Department of Medicine, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, MA, Boston, United States; Department of Epidemiology, School of Public Health, Boston University, MA, Boston, United States
Costanzo, Simona (författare)
Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
De Lemos, James A. (författare)
Department of Internal Medicine, UT Southwestern Medical Center, TX, Dallas, United States
Defilippi, Christopher R. (författare)
Inova Heart and Vascular Institute, VA, Falls Church, United States
Di Castelnuovo, Augusto (författare)
Mediterranea Cardiocentro, Naples, Italy
Donfrancesco, Chiara (författare)
Department of Cardiovascular Endocrine-Metabolic Diseases, and Aging, National Institute of Health, Rome, Italy
Dörr, Marcus (författare)
Department of Internal Medicine B, University Greifswald, Greifswald, Germany; German Center for Cardiovascular Research, Partner Site Greifswald, University Medicine, Greifswald, Germany
Eggers, Kai M. (författare)
Departments of Medical Sciences and Cardiology, Uppsala University, Uppsala, Sweden
Engström, Gunnar (författare)
Department of Clinical Sciences, Lund University, Malmö, Sweden
Felix, Stephan B. (författare)
Department of Internal Medicine B, University Greifswald, Greifswald, Germany; German Center for Cardiovascular Research, Partner Site Greifswald, University Medicine, Greifswald, Germany
Ferrario, Marco M. (författare)
Research Centre in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
Gansevoort, Ron T. (författare)
Department of Nephrology, University Medical Center Groningen, Groningen, Netherlands
Giampaoli, Simona (författare)
Istituto Superiore di Sanità, Rome, Italy
Giedraitis, Vilmantas (författare)
Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
Hedberg, Pär (författare)
Department of Clinical Physiology, Centre for Clinical Research, Västmanland County Hospital, Uppsala University, Västerås, Sweden
Iacoviello, Licia (författare)
Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy; Department of Medicine and Surgery, Libera Università Mediterranea, Casamassima, Italy
Jørgensen, Torben (författare)
Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Centre for Clinical Research and Prevention, BFH Hospital, Copenhagen, Denmark
Kee, Frank (författare)
UKCRC, Centre of Excellence for Public Health, Queens University of Belfast, Belfast, United Kingdom
Koenig, Wolfgang (författare)
German Heart Center, Technical University of Munich, Munich, Germany; Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; German Center for Cardiovascular Disease Research, Partner Site Munich Heart Alliance, Munich, Germany
Kuulasmaa, Kari (författare)
Finnish Institute for Health and Welfare, Helsinki, Finland
Lewis, Joshua R. (författare)
Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Medical School, University of Western Australia, Perth, Australia; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
Lorenz, Thiess (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Lyngbakken, Magnus N. (författare)
Division of Medicine, Department of Cardiology, Akershus University Hospital, Lorenskog, Norway; K. G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
Magnussen, Christina (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
Melander, Olle (författare)
Departments of Medical Sciences and Cardiology, Uppsala University, Uppsala, Sweden
Nauck, Matthias (författare)
German Center for Cardiovascular Research, Partner Site Greifswald, University Medicine, Greifswald, Germany; Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
Niiranen, Teemu J. (författare)
Finnish Institute for Health and Welfare, Helsinki, Finland; Division of Medicine, Turku University Hospital, Turku, Finland; Department of Internal Medicine, University of Turku, Turku, Finland
Nilsson, Peter M. (författare)
Departments of Medical Sciences and Cardiology, Uppsala University, Uppsala, Sweden
Olsen, Michael H. (författare)
Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark; Department of Regional Health, University of Southern Denmark, Odense, Denmark
Omland, Torbjorn (författare)
Division of Medicine, Department of Cardiology, Akershus University Hospital, Lorenskog, Norway; K. G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
Oskarsson, Viktor (författare)
Umeå universitet,Avdelningen för medicin
Palmieri, Luigi (författare)
Department of Cardiovascular Endocrine-Metabolic Diseases, and Aging, National Institute of Health, Rome, Italy
Peters, Anette (författare)
German Center for Cardiovascular Disease Research, Partner Site Munich Heart Alliance, Munich, Germany; Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany
Prince, Richard L. (författare)
Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
Qaderi, Vazhma (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Vasan, Ramachandran S. (författare)
Department of Medicine, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, MA, Boston, United States; University of Texas, School of Public Health, The University of Texas, Health Science Center, San Antonio, United States
Salomaa, Veikko (författare)
Finnish Institute for Health and Welfare, Helsinki, Finland
Sans, Susana (författare)
Catalan Department of Health, Barcelona, Spain
Smith, J. Gustav (författare)
Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, Gothenburg, Sweden
Söderberg, Stefan (författare)
Umeå universitet,Avdelningen för medicin
Thorand, Barbara (författare)
Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität, Munich, Germany
Tonkin, Andrew M. (författare)
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Tunstall-Pedoe, Hugh (författare)
Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Dundee, United Kingdom
Veronesi, Giovanni (författare)
Research Centre in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
Watanabe, Tetsu (författare)
Department of Cardiology Pulmonology, and Nephrology, School of Medicine, Yamagata University, Yamagata, Japan
Watanabe, Masafumi (författare)
Department of Cardiology Pulmonology, and Nephrology, School of Medicine, Yamagata University, Yamagata, Japan
Zeiher, Andreas M. (författare)
Institute for Cardiovascular Regeneration, Goethe University, Frankfurt, Germany; German Center for Cardiovascular Disease Research, Partner Site Rhine-Main, Mainz, Germany
Zeller, Tanja (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
Blankenberg, Stefan (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
Ojeda, Francisco (författare)
Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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 (creator_code:org_t)
2024
2024
Engelska.
Ingår i: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA). - 0098-7484 .- 1538-3598.
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Importance: Identification of individuals at high risk for atherosclerotic cardiovascular disease within the population is important to inform primary prevention strategies.Objective: To evaluate the prognostic value of routinely available cardiovascular biomarkers when added to established risk factors.Design, Setting, and Participants: Individual-level analysis including data on cardiovascular biomarkers from 28 general population-based cohorts from 12 countries and 4 continents with assessments by participant age. The median follow-up was 11.8 years.Exposure: Measurement of high-sensitivity cardiac troponin I, high-sensitivity cardiac troponin T, N-terminal pro-B-type natriuretic peptide, B-type natriuretic peptide, or high-sensitivity C-reactive protein.Main Outcomes and Measures: The primary outcome was incident atherosclerotic cardiovascular disease, which included all fatal and nonfatal events. The secondary outcomes were all-cause mortality, heart failure, ischemic stroke, and myocardial infarction. Subdistribution hazard ratios (HRs) for the association of biomarkers and outcomes were calculated after adjustment for established risk factors. The additional predictive value of the biomarkers was assessed using the C statistic and reclassification analyses.Results: The analyses included 164054 individuals (median age, 53.1 years [IQR, 42.7-62.9 years] and 52.4% were women). There were 17211 incident atherosclerotic cardiovascular disease events. All biomarkers were significantly associated with incident atherosclerotic cardiovascular disease (subdistribution HR per 1-SD change, 1.13 [95% CI, 1.11-1.16] for high-sensitivity cardiac troponin I; 1.18 [95% CI, 1.12-1.23] for high-sensitivity cardiac troponin T; 1.21 [95% CI, 1.18-1.24] for N-terminal pro-B-type natriuretic peptide; 1.14 [95% CI, 1.08-1.22] for B-type natriuretic peptide; and 1.14 [95% CI, 1.12-1.16] for high-sensitivity C-reactive protein) and all secondary outcomes. The addition of each single biomarker to a model that included established risk factors improved the C statistic. For 10-year incident atherosclerotic cardiovascular disease in younger people (aged <65 years), the combination of high-sensitivity cardiac troponin I, N-terminal pro-B-type natriuretic peptide, and high-sensitivity C-reactive protein resulted in a C statistic improvement from 0.812 (95% CI, 0.8021-0.8208) to 0.8194 (95% CI, 0.8089-0.8277). The combination of these biomarkers also improved reclassification compared with the conventional model. Improvements in risk prediction were most pronounced for the secondary outcomes of heart failure and all-cause mortality. The incremental value of biomarkers was greater in people aged 65 years or older vs younger people.Conclusions and Relevance: Cardiovascular biomarkers were strongly associated with fatal and nonfatal cardiovascular events and mortality. The addition of biomarkers to established risk factors led to only a small improvement in risk prediction metrics for atherosclerotic cardiovascular disease, but was more favorable for heart failure and mortality..

Ämnesord

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

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