Multimarker risk model containing troponin-T, interleukin 10, myeloperoxidase and placental growth factor predicts long-term cardiovascular risk after non-ST-segment elevation acute coronary syndrome
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Multimarker risk model containing troponin-T, interleukin 10, myeloperoxidase and placental growth factor predicts long-term cardiovascular risk after non-ST-segment elevation acute coronary syndrome. / Oemrawsingh, R M; Lenderink, T; Akkerhuis, K M; Heeschen, C; Baldus, S; Fichtlscherer, S; Hamm, C W; Simoons, M L; Boersma, E; CAPTURE investigators.
in: HEART, Jahrgang 97, Nr. 13, 07.2011, S. 1061-1066.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Multimarker risk model containing troponin-T, interleukin 10, myeloperoxidase and placental growth factor predicts long-term cardiovascular risk after non-ST-segment elevation acute coronary syndrome
AU - Oemrawsingh, R M
AU - Lenderink, T
AU - Akkerhuis, K M
AU - Heeschen, C
AU - Baldus, S
AU - Fichtlscherer, S
AU - Hamm, C W
AU - Simoons, M L
AU - Boersma, E
AU - CAPTURE investigators
PY - 2011/7
Y1 - 2011/7
N2 - OBJECTIVE: To evaluate the predictive value of seven biomarkers, which individually have been shown to be independent predictors, for use in a combined multimarker model for long-term cardiovascular outcome after non-ST-segment elevation acute coronary syndrome (NSTEACS).DESIGN AND SETTING: Levels of high-sensitivity C-reactive protein (hsCRP), myeloperoxidase, pregnancy-associated plasma protein A, placental growth factor (PlGF), soluble CD40 ligand (sCD40L), interleukin 10 (IL-10) and troponin-T (TnT) were determined in patients enrolled in the CAPTURE trial. Cox proportional hazard regression analyses were applied to evaluate the relation between biomarkers and the occurrence of all-cause mortality or non-fatal myocardial infarction (MI).PATIENTS: 1090 patients with NSTEACS.MAIN OUTCOME MEASURE: All-cause mortality and non-fatal MI during a median follow-up of 4 years.RESULTS: The composite endpoint was reached by 15.3% of patients. Admission levels of TnT >0.01 μg/l (adjusted HR 1.8), IL-10 <3.5 ng/l (1.7), myeloperoxidase >350 μg/l (1.5) and PlGF >27 ng/l (1.9) remained significant predictors for the incidence of all-cause mortality or non-fatal MI after multivariable adjustment for other biomarkers and clinical characteristics, whereas hsCRP, pregnancy-associated plasma protein A and sCD40L were only associated with the endpoint in univariate analysis. A multimarker model consisting of TnT, IL-10, myeloperoxidase and PlGF predicted 4-year event rates that varied between 6.0% (all markers normal) and 35.8% (three or more biomarkers abnormal).CONCLUSION: In patients with NSTEACS, biomarkers characterising distinct aspects of the underlying atherosclerotic process and myocardial damage of the initial cardiac event can assist in predicting long-term adverse cardiac outcomes. The use of combinations of selected biomarkers adds incremental predictive value to further risk stratification in an otherwise seemingly homogeneous NSTEACS population.
AB - OBJECTIVE: To evaluate the predictive value of seven biomarkers, which individually have been shown to be independent predictors, for use in a combined multimarker model for long-term cardiovascular outcome after non-ST-segment elevation acute coronary syndrome (NSTEACS).DESIGN AND SETTING: Levels of high-sensitivity C-reactive protein (hsCRP), myeloperoxidase, pregnancy-associated plasma protein A, placental growth factor (PlGF), soluble CD40 ligand (sCD40L), interleukin 10 (IL-10) and troponin-T (TnT) were determined in patients enrolled in the CAPTURE trial. Cox proportional hazard regression analyses were applied to evaluate the relation between biomarkers and the occurrence of all-cause mortality or non-fatal myocardial infarction (MI).PATIENTS: 1090 patients with NSTEACS.MAIN OUTCOME MEASURE: All-cause mortality and non-fatal MI during a median follow-up of 4 years.RESULTS: The composite endpoint was reached by 15.3% of patients. Admission levels of TnT >0.01 μg/l (adjusted HR 1.8), IL-10 <3.5 ng/l (1.7), myeloperoxidase >350 μg/l (1.5) and PlGF >27 ng/l (1.9) remained significant predictors for the incidence of all-cause mortality or non-fatal MI after multivariable adjustment for other biomarkers and clinical characteristics, whereas hsCRP, pregnancy-associated plasma protein A and sCD40L were only associated with the endpoint in univariate analysis. A multimarker model consisting of TnT, IL-10, myeloperoxidase and PlGF predicted 4-year event rates that varied between 6.0% (all markers normal) and 35.8% (three or more biomarkers abnormal).CONCLUSION: In patients with NSTEACS, biomarkers characterising distinct aspects of the underlying atherosclerotic process and myocardial damage of the initial cardiac event can assist in predicting long-term adverse cardiac outcomes. The use of combinations of selected biomarkers adds incremental predictive value to further risk stratification in an otherwise seemingly homogeneous NSTEACS population.
KW - Acute Coronary Syndrome/blood
KW - Aged
KW - Biomarkers/blood
KW - Electrocardiography
KW - Epidemiologic Methods
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Interleukin-10/blood
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/epidemiology
KW - Peroxidase/blood
KW - Placenta Growth Factor
KW - Pregnancy Proteins/blood
KW - Prognosis
KW - Troponin T/blood
U2 - 10.1136/hrt.2010.197392
DO - 10.1136/hrt.2010.197392
M3 - SCORING: Journal article
C2 - 21558475
VL - 97
SP - 1061
EP - 1066
JO - HEART
JF - HEART
SN - 1355-6037
IS - 13
ER -