Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease: A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
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Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease : A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial. / Winkel, Per; Jakobsen, Janus Christian; Hilden, Jørgen; Jensen, Gorm Boje; Kjøller, Erik; Sajadieh, Ahmad; Kastrup, Jens; Kolmos, Hans Jørn; Iversen, Kasper Karmark; Bjerre, Mette; Larsson, Anders; Ärnlöv, Johan; Gluud, Christian.
In: BMJ Open, Vol. 10, No. 8, e033720, 2020.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease
T2 - A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
AU - Winkel, Per
AU - Jakobsen, Janus Christian
AU - Hilden, Jørgen
AU - Jensen, Gorm Boje
AU - Kjøller, Erik
AU - Sajadieh, Ahmad
AU - Kastrup, Jens
AU - Kolmos, Hans Jørn
AU - Iversen, Kasper Karmark
AU - Bjerre, Mette
AU - Larsson, Anders
AU - Ärnlöv, Johan
AU - Gluud, Christian
PY - 2020
Y1 - 2020
N2 - OBJECTIVE: To assess if 12 novel circulating biomarkers, when added to 'standard predictors' available in general practice, could improve the 10-year prediction of cardiovascular events and mortality in patients with stable coronary heart disease. DESIGN: The patients participated as placebo receiving patients in the randomised clarithromycin for patients with stable coronary artery disease (CLARICOR) trial at a random time in their disease trajectory. SETTING: Five Copenhagen University cardiology departments and a coordinating centre. PARTICIPANTS: 1998 participants with stable coronary artery disease. OUTCOMES: Death and composite of myocardial infarction, unstable angina pectoris, cerebrovascular disease and death. RESULTS: When only 'standard predictors' were included, 83.4% of all-cause death predictions and 68.4% of composite outcome predictions were correct. Log(calprotectin) and log(cathepsin-S) were not associated (p≥0.01) with the outcomes, not even as single predictors. Adding the remaining 10 biomarkers (high-sensitive assay cardiac troponin T; neutrophil gelatinase-associated lipocalin; osteoprotegerin; N-terminal pro-B-type natriuretic peptide; tumour necrosis factor receptor 1 and 2; pregnancy-associated plasma protein A; endostatin; YKL40; cathepsin-B), which were all individually significantly associated with the prediction of the two outcomes, increased the figures to 84.7% and 69.7%. CONCLUSION: When 'standard predictors' routinely available in general practices are used for risk assessment in consecutively sampled patients with stable coronary artery disease, the addition of 10 novel biomarkers to the prediction model improved the correct prediction of all-cause death and the composite outcome by <1.5%. TRIAL REGISTRATION NUMBER: NCT00121550.
AB - OBJECTIVE: To assess if 12 novel circulating biomarkers, when added to 'standard predictors' available in general practice, could improve the 10-year prediction of cardiovascular events and mortality in patients with stable coronary heart disease. DESIGN: The patients participated as placebo receiving patients in the randomised clarithromycin for patients with stable coronary artery disease (CLARICOR) trial at a random time in their disease trajectory. SETTING: Five Copenhagen University cardiology departments and a coordinating centre. PARTICIPANTS: 1998 participants with stable coronary artery disease. OUTCOMES: Death and composite of myocardial infarction, unstable angina pectoris, cerebrovascular disease and death. RESULTS: When only 'standard predictors' were included, 83.4% of all-cause death predictions and 68.4% of composite outcome predictions were correct. Log(calprotectin) and log(cathepsin-S) were not associated (p≥0.01) with the outcomes, not even as single predictors. Adding the remaining 10 biomarkers (high-sensitive assay cardiac troponin T; neutrophil gelatinase-associated lipocalin; osteoprotegerin; N-terminal pro-B-type natriuretic peptide; tumour necrosis factor receptor 1 and 2; pregnancy-associated plasma protein A; endostatin; YKL40; cathepsin-B), which were all individually significantly associated with the prediction of the two outcomes, increased the figures to 84.7% and 69.7%. CONCLUSION: When 'standard predictors' routinely available in general practices are used for risk assessment in consecutively sampled patients with stable coronary artery disease, the addition of 10 novel biomarkers to the prediction model improved the correct prediction of all-cause death and the composite outcome by <1.5%. TRIAL REGISTRATION NUMBER: NCT00121550.
KW - biomarker
KW - cardiology
KW - coronary heart disease
U2 - 10.1136/bmjopen-2019-033720
DO - 10.1136/bmjopen-2019-033720
M3 - Journal article
C2 - 32819979
AN - SCOPUS:85089769818
VL - 10
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 8
M1 - e033720
ER -
ID: 248542977