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Sex- and age-related differences in the predictive capability of circulating biomarkers: from the MONICA 10 cohort

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@article{e2e1faef4878488d9edbf65991f0b30a,
title = "Sex- and age-related differences in the predictive capability of circulating biomarkers: from the MONICA 10 cohort",
abstract = "OBJECTIVES: The purpose of this study was to assess whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) differed in their ability to predict cardiovascular outcomes beyond traditional risk factors in younger and older men and women without known cardiovascular disease. Design. Prospective population-based cohort study of 1951 individuals from the MONItoring of trends and determinants in Cardiovascular disease (MONICA) study, examined 1993-1994. Participants were stratified into four groups based on sex and age. Subjects aged 41 or 51 years were classified as younger; those aged 61 or 71 years were classified as older. The principal endpoint was death from cardiovascular causes. Predictive capabilities of biomarkers were tested using Cox proportional-hazards regression, Harrell's concordance-index, net reclassification improvement, and classification and regression tree (CART) analysis. Results. Median follow-up was 18.5 years, during which 19/597 younger men, 100/380 older men, 12/607 younger women, and 46/367 older women had died from a cardiovascular cause. NT-proBNP was independently associated with death from cardiovascular causes among all participants (p ≤ .02) except younger women (p = .70), whereas hs-CRP was associated with this endpoint in men (p ≤ .007), and suPAR in older men only (p < .001). None of the biomarkers improved discrimination ability beyond traditional risk factors (p ≥ .07). However, NT-proBNP enhanced reclassification in men and older women. CART-analysis showed that NT-proBNP was generally of greater value among men, and suPAR among women. Conclusions. Hs-CRP, NT-proBNP, and suPAR displayed different associations with cardiovascular death among apparently healthy younger and older men and women.",
keywords = "Assessment, risk, biomarkers, cardiovascular diseases, C-reactive protein, natriuretic peptide, brain, receptor, urokinase plasminogen activator",
author = "Frary, {Charles E} and Tor Biering-S{\o}rensen and Kotaro Nochioka and Blicher, {Marie K} and Olesen, {Thomas B} and Stidsen, {Jacob V} and Greve, {Sara V} and Vishram-Nielsen, {Julie K K} and Rasmussen, {Susanne L} and Jesper Eugen-Olsen and Olsen, {Michael H} and Manan Pareek",
year = "2021",
doi = "10.1080/14017431.2020.1853217",
language = "English",
volume = "55",
pages = "65--72",
journal = "Scandinavian Cardiovascular Journal",
issn = "1401-7431",
publisher = "Informa Healthcare",
number = "2",

}

RIS

TY - JOUR

T1 - Sex- and age-related differences in the predictive capability of circulating biomarkers

T2 - from the MONICA 10 cohort

AU - Frary, Charles E

AU - Biering-Sørensen, Tor

AU - Nochioka, Kotaro

AU - Blicher, Marie K

AU - Olesen, Thomas B

AU - Stidsen, Jacob V

AU - Greve, Sara V

AU - Vishram-Nielsen, Julie K K

AU - Rasmussen, Susanne L

AU - Eugen-Olsen, Jesper

AU - Olsen, Michael H

AU - Pareek, Manan

PY - 2021

Y1 - 2021

N2 - OBJECTIVES: The purpose of this study was to assess whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) differed in their ability to predict cardiovascular outcomes beyond traditional risk factors in younger and older men and women without known cardiovascular disease. Design. Prospective population-based cohort study of 1951 individuals from the MONItoring of trends and determinants in Cardiovascular disease (MONICA) study, examined 1993-1994. Participants were stratified into four groups based on sex and age. Subjects aged 41 or 51 years were classified as younger; those aged 61 or 71 years were classified as older. The principal endpoint was death from cardiovascular causes. Predictive capabilities of biomarkers were tested using Cox proportional-hazards regression, Harrell's concordance-index, net reclassification improvement, and classification and regression tree (CART) analysis. Results. Median follow-up was 18.5 years, during which 19/597 younger men, 100/380 older men, 12/607 younger women, and 46/367 older women had died from a cardiovascular cause. NT-proBNP was independently associated with death from cardiovascular causes among all participants (p ≤ .02) except younger women (p = .70), whereas hs-CRP was associated with this endpoint in men (p ≤ .007), and suPAR in older men only (p < .001). None of the biomarkers improved discrimination ability beyond traditional risk factors (p ≥ .07). However, NT-proBNP enhanced reclassification in men and older women. CART-analysis showed that NT-proBNP was generally of greater value among men, and suPAR among women. Conclusions. Hs-CRP, NT-proBNP, and suPAR displayed different associations with cardiovascular death among apparently healthy younger and older men and women.

AB - OBJECTIVES: The purpose of this study was to assess whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) differed in their ability to predict cardiovascular outcomes beyond traditional risk factors in younger and older men and women without known cardiovascular disease. Design. Prospective population-based cohort study of 1951 individuals from the MONItoring of trends and determinants in Cardiovascular disease (MONICA) study, examined 1993-1994. Participants were stratified into four groups based on sex and age. Subjects aged 41 or 51 years were classified as younger; those aged 61 or 71 years were classified as older. The principal endpoint was death from cardiovascular causes. Predictive capabilities of biomarkers were tested using Cox proportional-hazards regression, Harrell's concordance-index, net reclassification improvement, and classification and regression tree (CART) analysis. Results. Median follow-up was 18.5 years, during which 19/597 younger men, 100/380 older men, 12/607 younger women, and 46/367 older women had died from a cardiovascular cause. NT-proBNP was independently associated with death from cardiovascular causes among all participants (p ≤ .02) except younger women (p = .70), whereas hs-CRP was associated with this endpoint in men (p ≤ .007), and suPAR in older men only (p < .001). None of the biomarkers improved discrimination ability beyond traditional risk factors (p ≥ .07). However, NT-proBNP enhanced reclassification in men and older women. CART-analysis showed that NT-proBNP was generally of greater value among men, and suPAR among women. Conclusions. Hs-CRP, NT-proBNP, and suPAR displayed different associations with cardiovascular death among apparently healthy younger and older men and women.

KW - Assessment

KW - risk

KW - biomarkers

KW - cardiovascular diseases

KW - C-reactive protein

KW - natriuretic peptide

KW - brain

KW - receptor

KW - urokinase plasminogen activator

U2 - 10.1080/14017431.2020.1853217

DO - 10.1080/14017431.2020.1853217

M3 - Journal article

C2 - 33251867

VL - 55

SP - 65

EP - 72

JO - Scandinavian Cardiovascular Journal

JF - Scandinavian Cardiovascular Journal

SN - 1401-7431

IS - 2

ER -

ID: 61349177