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Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus

Haller, Paul M. (author)
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
Goßling, Alina (author)
Department for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
Magnussen, Christina (author)
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
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Brenner, Hermann (author)
German Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 280, Heidelberg, Germany
Schöttker, Ben (author)
German Cancer Research Center, Division of Clinical Epidemiology and Aging Research, Im Neuenheimer Feld 280, Heidelberg, Germany
Iacoviello, Licia (author)
1) 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
Costanzo, Simona (author)
1) Department of Epidemiology and Prevention, IRCCS NEUROMED, Via Atinense ,18, Pozzilli, Italy
Kee, Frank (author)
Centre for Public Health, Queens University of Belfast, Belfast, United Kingdom
Koenig, Wolfgang (author)
Klinik 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
Linneberg, Allan (author)
Center 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
Sujana, Chaterina (author)
Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology, Ingolstädter Landstraße 1, Germany
Thorand, Barbara (author)
Helmholtz 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
Salomaa, Veikko (author)
Finnish Institute for Health and Welfare, Department of Public Health and Welfare, P.O. Box 30, Helsinki, Finland
Niiranen, Teemu J. (author)
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
Söderberg, Stefan (author)
Umeå universitet,Institutionen för folkhälsa och klinisk medicin
Völzke, Henry (author)
Institut 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
Dörr, Marcus (author)
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
Sans, Susana (author)
Catalan Department of Health, Roc Boronat, Barcelona, Spain
Padró, Teresa (author)
Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
Felix, Stephan B. (author)
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
Nauck, Matthias (author)
German 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
Petersmann, Astrid (author)
Institute 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
Palmieri, Luigi (author)
Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, 299 Viale Regina Elena, Rome, Italy
Donfrancesco, Chiara (author)
Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, 299 Viale Regina Elena, Rome, Italy
De Ponti, Roberto (author)
Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Via O. Rossi 9, Varese, Italy
Veronesi, Giovanni (author)
Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Via O. Rossi 9, Varese, Italy
Ferrario, Marco M. (author)
Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Via O. Rossi 9, Varese, Italy
Kuulasmaa, Kari (author)
Finnish Institute for Health and Welfare, Department of Public Health and Welfare, P.O. Box 30, Helsinki, Finland
Zeller, Tanja (author)
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
Ojeda, Francisco M. (author)
Department for Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
Blankenberg, Stefan (author)
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
Westermann, Dirk (author)
Department of Cardiology and Angiology, University Heart Center Freiburg • Bad Krozingen, Freiburg, Germany
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 (creator_code:org_t)
2023
2023
English.
In: European Journal of Preventive Cardiology. - 2047-4873 .- 2047-4881. ; 30:12, s. 1218-1226
Related links:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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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.

Subject headings

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 -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Keyword

Biomarkers
Cardiovascular events
Diabetes
hs-CRP
hs-cTnI
NT-proBNP

Publication and Content Type

ref (subject category)
art (subject category)

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