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Biomarker-Based Ris...
Biomarker-Based Risk Model to Predict Cardiovascular Mortality in Patients With Stable Coronary Disease
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- Lindholm, Daniel, 1982- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Lindbäck, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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Armstrong, Paul W. (author)
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Budaj, Andrzej (author)
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Cannon, Christopher P. (author)
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Granger, Christopher B. (author)
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- Hagström, Emil (author)
- Uppsala universitet,Kardiologi
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- Held, Claes, 1956- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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Koenig, Wolfgang (author)
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- Östlund, Ollie (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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Stewart, Ralph A.H. (author)
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Soffer, Joseph (author)
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White, Harvey D. (author)
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de Winter, Robbert J. (author)
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Steg, Philippe Gabriel (author)
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi
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Kleber, Marcus E. (author)
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Dressel, Alexander (author)
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Grammer, Tanja B. (author)
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März, Winfried (author)
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- Elsevier, 2017
- 2017
- English.
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In: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 70:7, s. 813-826
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https://doi.org/10.1...
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Abstract
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- Background Currently, there is no generally accepted model to predict outcomes in stable coronary heart disease (CHD).Objectives This study evaluated and compared the prognostic value of biomarkers and clinical variables to develop a biomarker-based prediction model in patients with stable CHD.Methods In a prospective, randomized trial cohort of 13,164 patients with stable CHD, we analyzed several candidate biomarkers and clinical variables and used multivariable Cox regression to develop a clinical prediction model based on the most important markers. The primary outcome was cardiovascular (CV) death, but model performance was also explored for other key outcomes. It was internally bootstrap validated, and externally validated in 1,547 patients in another study.Results During a median follow-up of 3.7 years, there were 591 cases of CV death. The 3 most important biomarkers were N-terminal pro–B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), and low-density lipoprotein cholesterol, where NT-proBNP and hs-cTnT had greater prognostic value than any other biomarker or clinical variable. The final prediction model included age (A), biomarkers (B) (NT-proBNP, hs-cTnT, and low-density lipoprotein cholesterol), and clinical variables (C) (smoking, diabetes mellitus, and peripheral arterial disease). This “ABC-CHD” model had high discriminatory ability for CV death (c-index 0.81 in derivation cohort, 0.78 in validation cohort), with adequate calibration in both cohorts.Conclusions This model provided a robust tool for the prediction of CV death in patients with stable CHD. As it is based on a small number of readily available biomarkers and clinical factors, it can be widely employed to complement clinical assessment and guide management based on CV risk. (The Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy Trial [STABILITY]; NCT00799903)
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- cardiac troponin
- low-density lipoprotein cholesterol
- N-terminal pro-B-type natriuretic peptide
- risk prediction
Publication and Content Type
- ref (subject category)
- art (subject category)
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Lindholm, Daniel ...
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Lindbäck, Johan
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Armstrong, Paul ...
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Budaj, Andrzej
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Cannon, Christop ...
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Granger, Christo ...
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Hagström, Emil
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Held, Claes, 195 ...
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Koenig, Wolfgang
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Östlund, Ollie
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Stewart, Ralph A ...
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Soffer, Joseph
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White, Harvey D.
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de Winter, Robbe ...
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Steg, Philippe G ...
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Siegbahn, Agneta ...
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Kleber, Marcus E ...
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Dressel, Alexand ...
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Grammer, Tanja B ...
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März, Winfried
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Wallentin, Lars, ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Uppsala University