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@ARTICLE{Haller:276226,
      author       = {P. M. Haller and A. Goßling and C. Magnussen and H.
                      Brenner$^*$ and B. Schöttker$^*$ and L. Iacoviello and S.
                      Costanzo and F. Kee and W. Koenig and A. Linneberg and C.
                      Sujana and B. Thorand and V. Salomaa and T. J. Niiranen and
                      S. Söderberg and H. Völzke and M. Dörr and S. Sans and T.
                      Padró and S. B. Felix and M. Nauck and A. Petersmann and L.
                      Palmieri and C. Donfrancesco and R. De Ponti and G. Veronesi
                      and M. M. Ferrario and K. Kuulasmaa and T. Zeller and F.
                      Ojeda and S. Blankenberg and D. Westermann},
      collaboration = {B. Consortium},
      title        = {{B}iomarker-based prediction of fatal and non-fatal
                      cardiovascular outcomes in individuals with diabetes
                      mellitus.},
      journal      = {European journal of preventive cardiology},
      volume       = {30},
      number       = {12},
      issn         = {2047-4873},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2023-01035},
      pages        = {1218-1226},
      year         = {2023},
      note         = {2023 Sep 6;30(12):1218-1226},
      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.},
      keywords     = {NT-proBNP (Other) / biomarkers (Other) / cardiovascular
                      events (Other) / diabetes (Other) / hs-CRP (Other) / hs-cTnI
                      (Other)},
      cin          = {C070},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37079290},
      doi          = {10.1093/eurjpc/zwad122},
      url          = {https://inrepo02.dkfz.de/record/276226},
}