Journal Article

DKFZ-2023-01035

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus.

Haller, P. M. ; Goßling, A. ; Magnussen, C. ; Brenner, H.DKFZ* ; Schöttker, B.DKFZ* ; Iacoviello, L. ; Costanzo, S. ; Kee, F. ; Koenig, W. ; Linneberg, A. ; Sujana, C. ; Thorand, B. ; Salomaa, V. ; Niiranen, T. J. ; Söderberg, S. ; Völzke, H. ; Dörr, M. ; Sans, S. ; Padró, T. ; Felix, S. B. ; Nauck, M. ; Petersmann, A. ; Palmieri, L. ; Donfrancesco, C. ; De Ponti, R. ; Veronesi, G. ; Ferrario, M. M. ; Kuulasmaa, K. ; Zeller, T. ; Ojeda, F. ; Blankenberg, S. ; Westermann, D. ; Consortium, B. (Collaboration Author)

2023
Oxford University Press Oxford

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Please use a persistent id in citations: doi:10.1093/eurjpc/zwad122

Abstract: The role of biomarkers in predicting cardiovascular outcomes in high-risk individuals is not well established. We aimed to investigate benefits of adding biomarkers to cardiovascular risk assessment in individuals with and without diabetes.We used individual-level data of 95,292 individuals of the European population harmonized in the BiomarCaRE consortium and investigated the prognostic ability of high-sensitivity cardiac troponin I (hs-cTnI), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP). Cox-regression models were used to determine adjusted hazard ratios (adj-HR) of diabetes and log-transformed biomarkers for fatal and non-fatal cardiovascular events. Models were compared using the likelihood ratio test. Stratification by specific biomarker cut-offs was performed for crude time-to-event analysis using Kaplan-Meier-plots.Overall, 6,090 (6.4%) individuals had diabetes at baseline, median follow-up was 9.9 years. Adjusting for classical risk factors and biomarkers, diabetes (HR 2.11 [95% CI 1.92, 2.32]), and all biomarkers (HR per interquartile range hs-cTnI 1.08 [95% CI 1.04, 1.12]; NT-proBNP 1.44 [95% CI 1.37, 1.53]; hs-CRP 1.27 [95% CI 1.21, 1.33]) were independently associated with cardiovascular events. Specific cut-offs for each biomarker identified a high-risk group of individuals with diabetes losing a median of 15.5 years of life compared to diabetics without elevated biomarkers. Addition of biomarkers to the Cox-model significantly improved the prediction of outcomes (likelihood ratio test for nested models p < 0.001), accompanied by an increase in the c-index (increase to 0.81).Biomarkers improve cardiovascular risk prediction in individuals with and without diabetes and facilitate the identification of individuals with diabetes at highest risk for cardiovascular events.

Keyword(s): NT-proBNP ; biomarkers ; cardiovascular events ; diabetes ; hs-CRP ; hs-cTnI

Note: 2023 Sep 6;30(12):1218-1226

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Contributing Institute(s):

1. C070 Klinische Epidemiologie und Alternf. (C070)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2023

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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