Graciela Delgado1, Rüdiger Siekmeier2, Bernhard K Krämer1, Winfried März3, Marcus E Kleber4. 1. Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. 2. Drug Regulatory Affairs, Pharmaceutical Institute, Bonn University, Bonn, Germany. 3. Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Synlab Academy, Synlab Services GmbH, Mannheim, Germany. 4. Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. Electronic address: Marcus.kleber@medma.uni-heidelberg.de.
Abstract
BACKGROUND: Cotinine is one of the major metabolites of nicotine. The aim our study was to investigate cotinine as a marker for individual risk prediction in the Ludwigshafen Risk and Cardiovascular Health study. METHODS: 840 samples had detectable cotinine measured using a radioimmunoassay (RIA nicotine metabolite, DPC Biermann GmbH). The distribution of risk factors across quartiles of cotinine or pack-years was analyzed by ANOVA and the association of cotinine and pack-years with mortality by Cox regression. RESULTS: Cotinine and pack-years both showed significant association with mortality in adjusted models with HRs (95% CI) of 1.30 (1.17-1.44) and 1.26 (1.13-1.42) comparing the third to the first tertile for cotinine and pack-years, respectively. Either cotinine or pack-years or self-reported smoking increased the area-under-the-curve significantly as compared to a basic model including other risk factors. DISCUSSION: Cotinine is a strong predictor of mortality in non-smokers as well as in smokers. As objectively measurable parameter cotinine would be preferable for risk prediction.
BACKGROUND:Cotinine is one of the major metabolites of nicotine. The aim our study was to investigate cotinine as a marker for individual risk prediction in the Ludwigshafen Risk and Cardiovascular Health study. METHODS: 840 samples had detectable cotinine measured using a radioimmunoassay (RIA nicotine metabolite, DPC Biermann GmbH). The distribution of risk factors across quartiles of cotinine or pack-years was analyzed by ANOVA and the association of cotinine and pack-years with mortality by Cox regression. RESULTS:Cotinine and pack-years both showed significant association with mortality in adjusted models with HRs (95% CI) of 1.30 (1.17-1.44) and 1.26 (1.13-1.42) comparing the third to the first tertile for cotinine and pack-years, respectively. Either cotinine or pack-years or self-reported smoking increased the area-under-the-curve significantly as compared to a basic model including other risk factors. DISCUSSION: Cotinine is a strong predictor of mortality in non-smokers as well as in smokers. As objectively measurable parameter cotinine would be preferable for risk prediction.
Authors: Setor K Kunutsor; Julia M Spee; Lyanne M Kieneker; Ron T Gansevoort; Robin P F Dullaart; Albert-Jan Voerman; Daan J Touw; Stephan J L Bakker Journal: J Am Heart Assoc Date: 2018-05-02 Impact factor: 5.501