BACKGROUND: There is continuous debate to the use of biomarkers in the general practitioners office and to what degree the established biomarkers N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitive C-reactive protein (hs-CRP) might contribute to improved prediction of incident cardiovascular events. OBJECTIVE: To evaluate the utility and 5-year predictive value of a single measurement of NT-pro-BNP and hs-CRP for incident cardiovascular events, and its added value beyond the contribution of conventional risk factors in primary care. METHODS: Five year prospective longitudinal clinical epidemiological study in a nationwide sample of 4,775 primary care subjects (mean age 55.8 years, 62 % women) without coronary artery disease at baseline. Main outcome measures were incident major cardiovascular events and all-cause death. RESULTS: During the 5 years of follow-up, 188 subjects (3.9 %) died or experienced a first major cardiovascular event. The addition of NT-pro-BNP, but not of hs-CRP to a prediction model with established cardiovascular risk factors improved the prediction of major cardiovascular events (increase in C statistic by 0.009; p = 0.008), and was associated with a significant improvement in net reclassification improvement (NRI = 23.6 %; p = 0.003). CONCLUSION: In a primary care setting, one single measurement of NT-pro-BNP, but not of hs-CRP significantly improves the prediction of incident cardiovascular events.
BACKGROUND: There is continuous debate to the use of biomarkers in the general practitioners office and to what degree the established biomarkers N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitive C-reactive protein (hs-CRP) might contribute to improved prediction of incident cardiovascular events. OBJECTIVE: To evaluate the utility and 5-year predictive value of a single measurement of NT-pro-BNP and hs-CRP for incident cardiovascular events, and its added value beyond the contribution of conventional risk factors in primary care. METHODS: Five year prospective longitudinal clinical epidemiological study in a nationwide sample of 4,775 primary care subjects (mean age 55.8 years, 62 % women) without coronary artery disease at baseline. Main outcome measures were incident major cardiovascular events and all-cause death. RESULTS: During the 5 years of follow-up, 188 subjects (3.9 %) died or experienced a first major cardiovascular event. The addition of NT-pro-BNP, but not of hs-CRP to a prediction model with established cardiovascular risk factors improved the prediction of major cardiovascular events (increase in C statistic by 0.009; p = 0.008), and was associated with a significant improvement in net reclassification improvement (NRI = 23.6 %; p = 0.003). CONCLUSION: In a primary care setting, one single measurement of NT-pro-BNP, but not of hs-CRP significantly improves the prediction of incident cardiovascular events.
Authors: Thomas A Pearson; Steven N Blair; Stephen R Daniels; Robert H Eckel; Joan M Fair; Stephen P Fortmann; Barry A Franklin; Larry B Goldstein; Philip Greenland; Scott M Grundy; Yuling Hong; Nancy Houston Miller; Ronald M Lauer; Ira S Ockene; Ralph L Sacco; James F Sallis; Sidney C Smith; Neil J Stone; Kathryn A Taubert Journal: Circulation Date: 2002-07-16 Impact factor: 29.690
Authors: Stefan Blankenberg; Matthew J McQueen; Marek Smieja; Janice Pogue; Cynthia Balion; Eva Lonn; Hans J Rupprecht; Christoph Bickel; Laurence Tiret; Francois Cambien; Hertzel Gerstein; Thomas Münzel; Salim Yusuf Journal: Circulation Date: 2006-07-10 Impact factor: 29.690
Authors: Umesh N Khot; Monica B Khot; Christopher T Bajzer; Shelly K Sapp; E Magnus Ohman; Sorin J Brener; Stephen G Ellis; A Michael Lincoff; Eric J Topol Journal: JAMA Date: 2003-08-20 Impact factor: 56.272
Authors: Stefan Blankenberg; Tanja Zeller; Olli Saarela; Aki S Havulinna; Frank Kee; Hugh Tunstall-Pedoe; Kari Kuulasmaa; John Yarnell; Renate B Schnabel; Philipp S Wild; Thomas F Münzel; Karl J Lackner; Laurence Tiret; Alun Evans; Veikko Salomaa Journal: Circulation Date: 2010-05-24 Impact factor: 29.690
Authors: M Weber; C Kleine; E Keil; M Rau; A Berkowitsch; A Elsaesser; V Mitrovic; C Hamm Journal: Clin Res Cardiol Date: 2006-03-21 Impact factor: 6.138
Authors: Kaffer Kara; Amir A Mahabadi; Marie H Geisel; Nils Lehmann; Hagen Kälsch; Marcus Bauer; Till Neumann; Nico Dragano; Susanne Moebus; Stefan Möhlenkamp; Karl-Heinz Jöckel; Raimund Erbel Journal: Clin Res Cardiol Date: 2013-10-15 Impact factor: 5.460
Authors: Benjamin N Schaeffer; Meike Rybczynski; Sara Sheikhzadeh; Ruken Ö Akbulak; Julia Moser; Mario Jularic; Doreen Schreiber; Anne Daubmann; Stephan Willems; Yskert von Kodolitsch; Boris A Hoffmann Journal: Clin Res Cardiol Date: 2015-06-02 Impact factor: 5.460
Authors: Arnt V Kristen; Johannes Rinn; Ute Hegenbart; David Lindenmaier; Corina Merkle; Christoph Röcken; Stefan Hardt; Evangelos Giannitsis; Hugo A Katus Journal: Clin Res Cardiol Date: 2014-10-21 Impact factor: 5.460
Authors: Christoph Sinning; Arne Kieback; Philipp S Wild; Renate B Schnabel; Francisco Ojeda; Sebastian Appelbaum; Tanja Zeller; Edith Lubos; Edzard Schwedhelm; Karl J Lackner; Eike S Debus; Thomas Munzel; Stefan Blankenberg; Christine Espinola-Klein Journal: Clin Res Cardiol Date: 2014-02-02 Impact factor: 5.460
Authors: Jacek Budzyński; Marek Koziński; Maria Kłopocka; Julia Maria Kubica; Jacek Kubica Journal: Clin Res Cardiol Date: 2014-05-10 Impact factor: 5.460