AIMS: Several biomarkers including B-type natriuretic peptide (BNP) have been suggested to improve prediction of coronary events and all-cause mortality. Moreover, coronary artery calcium (CAC) as marker of subclinical atherosclerosis is a strong predictor for cardiovascular mortality and morbidity. We aimed to evaluate the predictive ability of BNP and CAC for all-cause mortality and coronary events above traditional cardiovascular risk factors (TRF) in the general population. METHODS: We followed 3782 participants of the population-based Heinz Nixdorf Recall cohort study without coronary artery disease at baseline for 7.3 ± 1.3 years. Associations of BNP and CAC with incident coronary events and all-cause mortality were assessed using Cox regression, Harrell's c, and time-dependent integrated discrimination improvement (IDI(t), increase in explained variance). RESULTS: Subjects with high BNP levels had increased frequency of coronary events and death (coronary events/mortality: 14.1/28.2% for BNP ≥100 pg/ml vs. 2.7/5.5% for BNP < 100 pg/ml, respectively). Subjects with a BNP ≥100 pg/ml had increased incidence of hard endpoints sustaining adjustment for CAC and TRF (for coronary events: hazard ratio (HR) (95% confidence interval (CI)) 3.41(1.78-6.53); for all-cause mortality: HR 3.35(2.15-5.23)). Adding BNP to TRF and CAC increased measures of predictive ability: coronary events (Harrell's c, for coronary events, 0.775-0.784, p = 0.09; for all-cause mortality 0.733-0.740, p = 0.04; and IDI(t) (95% CI), for coronary events: 2.79% (0.33-5.65%) and for all-cause mortality 1.78% (0.73-3.10%). CONCLUSIONS: Elevated levels of BNP are associated with excess incident coronary events and all-cause mortality rates, with BNP and CAC significantly and complementary improving prediction of risk in the general population above TRF.
AIMS: Several biomarkers including B-type natriuretic peptide (BNP) have been suggested to improve prediction of coronary events and all-cause mortality. Moreover, coronary artery calcium (CAC) as marker of subclinical atherosclerosis is a strong predictor for cardiovascular mortality and morbidity. We aimed to evaluate the predictive ability of BNP and CAC for all-cause mortality and coronary events above traditional cardiovascular risk factors (TRF) in the general population. METHODS: We followed 3782 participants of the population-based Heinz Nixdorf Recall cohort study without coronary artery disease at baseline for 7.3 ± 1.3 years. Associations of BNP and CAC with incident coronary events and all-cause mortality were assessed using Cox regression, Harrell's c, and time-dependent integrated discrimination improvement (IDI(t), increase in explained variance). RESULTS: Subjects with high BNP levels had increased frequency of coronary events and death (coronary events/mortality: 14.1/28.2% for BNP ≥100 pg/ml vs. 2.7/5.5% for BNP < 100 pg/ml, respectively). Subjects with a BNP ≥100 pg/ml had increased incidence of hard endpoints sustaining adjustment for CAC and TRF (for coronary events: hazard ratio (HR) (95% confidence interval (CI)) 3.41(1.78-6.53); for all-cause mortality: HR 3.35(2.15-5.23)). Adding BNP to TRF and CAC increased measures of predictive ability: coronary events (Harrell's c, for coronary events, 0.775-0.784, p = 0.09; for all-cause mortality 0.733-0.740, p = 0.04; and IDI(t) (95% CI), for coronary events: 2.79% (0.33-5.65%) and for all-cause mortality 1.78% (0.73-3.10%). CONCLUSIONS: Elevated levels of BNP are associated with excess incident coronary events and all-cause mortality rates, with BNP and CAC significantly and complementary improving prediction of risk in the general population above TRF.
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: Adam Mitchell; Jeffrey R Misialek; Aaron R Folsom; Daniel Duprez; Alvaro Alonso; Michael Jerosch-Herold; Otto A Sanchez; Karol E Watson; Tamer Sallam; Suma H Konety Journal: Am J Cardiol Date: 2015-02-18 Impact factor: 2.778
Authors: Alan Cheng; Yiyi Zhang; Elena Blasco-Colmenares; Darshan Dalal; Barbara Butcher; Sanaz Norgard; Zayd Eldadah; Kenneth A Ellenbogen; Timm Dickfeld; David D Spragg; Joseph E Marine; Eliseo Guallar; Gordon F Tomaselli Journal: Circ Arrhythm Electrophysiol Date: 2014-10-01
Authors: Bernt Johan von Scholten; Henrik Reinhard; Tine Willum Hansen; Morten Lindhardt; Claus Leth Petersen; Niels Wiinberg; Peter Riis Hansen; Hans-Henrik Parving; Peter Karl Jacobsen; Peter Rossing Journal: Cardiovasc Diabetol Date: 2015-05-21 Impact factor: 9.951
Authors: Jonas Rusnak; Michael Behnes; Thomas Henzler; Nadine Reckord; Nils Vogler; Mathias Meyer; Ursula Hoffmann; Michele Natale; Julia Hoffmann; Sonja Hamed; Kathrin Weidner; Siegfried Lang; Agnibh Mukherji; Holger Haubenreisser; Stefan O Schoenberg; Martin Borggrefe; Thomas Bertsch; Ibrahim Akin Journal: Eur J Med Res Date: 2017-11-16 Impact factor: 2.175