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https://doi.org/10.1016/j.ebiom.2022.104170
Title: | Circulating cardiac biomarkers improve risk stratification for incident cardiovascular disease in community dwelling populations | Authors: | Wu, Z Pilbrow, AP Liew, OW Chong, JPC Sluyter, J Lewis, LK Lasse, M Frampton, CM Jackson, R Poppe, K Camargo, CA Cameron, VA Scragg, R Richards, AM |
Keywords: | Cardiac biomarkers Community populations Epidemiology Incident cardiovascular disease Risk stratification Biomarkers Cardiovascular Diseases Humans Independent Living Laboratories Natriuretic Peptide, Brain Peptide Fragments Risk Assessment Risk Factors Troponin I Troponin T Vitamin D |
Issue Date: | 1-Aug-2022 | Publisher: | Elsevier BV | Citation: | Wu, Z, Pilbrow, AP, Liew, OW, Chong, JPC, Sluyter, J, Lewis, LK, Lasse, M, Frampton, CM, Jackson, R, Poppe, K, Camargo, CA, Cameron, VA, Scragg, R, Richards, AM (2022-08-01). Circulating cardiac biomarkers improve risk stratification for incident cardiovascular disease in community dwelling populations. eBioMedicine 82 : 104170-. ScholarBank@NUS Repository. https://doi.org/10.1016/j.ebiom.2022.104170 | Abstract: | Background: Plasma cardiac markers may assist in prediction of incident cardiovascular disease. Methods: The incremental value of cardiac Troponins (T and I) and NT-proBNP added to risk factors in the PREDICT score for incident cardiovascular disease (CVD) in primary care, was assessed in 4102 asymptomatic participants in a randomised controlled trial of Vitamin D (ViDA). Findings were corroborated in 2528 participants in a separate community-based observational registry of CVD-free volunteers (HVOLS). Findings: Hazard ratios for first cardiovascular events adjusted for PREDICT risk factors, comparing fifth to first quintiles of marker plasma concentrations, were 2.57 (95% CI 1.47-4.49); 3.01 (1.66-5.48) and 3.38 (2.04-5.60) for hs-cTnI, hs-cTnT and NT-proBNP respectively. The C statistic for discrimination of the primary endpoint increased from 0.755 to 0.771 (+0.016, p = 0.01). Cardiac marker data correctly reclassified risk upwards in 6.7% of patients and downwards in 3.3%. These findings were corroborated by results from HVOLS. Interpretation: Increments in plasma cardiac biomarkers robustly and reproducibly predicted increased hazard of incident CVD, independent of established risk factors, in two community-dwelling populations. Cardiac markers may augment risk assessment for onset of CVD in primary care. Funding: ViDA was funded by the Health Research Council of New Zealand (grant 10/400) and the Accident Compensation Corporation. HVOLS was funded by the Health Research Council of NZ Programme Grants (grants 02/152 and 08/070) and by grants from the Heart Foundation of NZ and the Christchurch Heart Institute Trust. Roche Diagnostics provided in-kind support for NT-proBNP and hs-cTnT assays and Abbott Laboratories for hs-cTnI assays. | Source Title: | eBioMedicine | URI: | https://scholarbank.nus.edu.sg/handle/10635/241787 | ISSN: | 2352-3964 | DOI: | 10.1016/j.ebiom.2022.104170 |
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