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Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus

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Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus. / Haller, Paul M; Goßling, Alina; Magnussen, Christina; Brenner, Hermann; Schöttker, Ben; Iacoviello, Licia; Costanzo, Simona; Kee, Frank; Koenig, Wolfgang; Linneberg, Allan; Sujana, Chaterina; Thorand, Barbara; Salomaa, Veikko; Niiranen, Teemu J; Söderberg, Stefan; Völzke, Henry; Dörr, Marcus; Sans, Susana; Padró, Teresa; Felix, Stephan B; Nauck, Matthias; Petersmann, Astrid; Palmieri, Luigi; Donfrancesco, Chiara; De Ponti, Roberto; Veronesi, Giovanni; Ferrario, Marco M; Kuulasmaa, Kari; Zeller, Tanja; Ojeda, Francisco; Blankenberg, Stefan; Westermann, Dirk; BiomarCaRE Consortium.

In: EUR J PREV CARDIOL, Vol. 30, No. 12, 06.09.2023, p. 1218-1226.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Haller, PM, Goßling, A, Magnussen, C, Brenner, H, Schöttker, B, Iacoviello, L, Costanzo, S, Kee, F, Koenig, W, Linneberg, A, Sujana, C, Thorand, B, Salomaa, V, Niiranen, TJ, Söderberg, S, Völzke, H, Dörr, M, Sans, S, Padró, T, Felix, SB, Nauck, M, Petersmann, A, Palmieri, L, Donfrancesco, C, De Ponti, R, Veronesi, G, Ferrario, MM, Kuulasmaa, K, Zeller, T, Ojeda, F, Blankenberg, S, Westermann, D & BiomarCaRE Consortium 2023, 'Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus', EUR J PREV CARDIOL, vol. 30, no. 12, pp. 1218-1226. https://doi.org/10.1093/eurjpc/zwad122

APA

Haller, P. M., Goßling, A., Magnussen, C., Brenner, H., Schöttker, B., 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., ... BiomarCaRE Consortium (2023). Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus. EUR J PREV CARDIOL, 30(12), 1218-1226. https://doi.org/10.1093/eurjpc/zwad122

Vancouver

Haller PM, Goßling A, Magnussen C, Brenner H, Schöttker B, Iacoviello L et al. Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus. EUR J PREV CARDIOL. 2023 Sep 6;30(12):1218-1226. https://doi.org/10.1093/eurjpc/zwad122

Bibtex

@article{2dadfcc0ac89475592031e267e7bb6ff,
title = "Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus",
abstract = "AIMS: 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.METHODS AND RESULTS: We used individual-level data of 95 292 individuals of the European population harmonized in the Biomarker for Cardiovascular Risk Assessment across Europe 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 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, 6090 (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).CONCLUSION: 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.",
author = "Haller, {Paul M} and Alina Go{\ss}ling and Christina Magnussen and Hermann Brenner and Ben Sch{\"o}ttker and Licia Iacoviello and Simona Costanzo and Frank Kee and Wolfgang Koenig and Allan Linneberg and Chaterina Sujana and Barbara Thorand and Veikko Salomaa and Niiranen, {Teemu J} and Stefan S{\"o}derberg and Henry V{\"o}lzke and Marcus D{\"o}rr and Susana Sans and Teresa Padr{\'o} and Felix, {Stephan B} and Matthias Nauck and Astrid Petersmann and Luigi Palmieri and Chiara Donfrancesco and {De Ponti}, Roberto and Giovanni Veronesi and Ferrario, {Marco M} and Kari Kuulasmaa and Tanja Zeller and Francisco Ojeda and Stefan Blankenberg and Dirk Westermann and {BiomarCaRE Consortium}",
note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
year = "2023",
month = sep,
day = "6",
doi = "10.1093/eurjpc/zwad122",
language = "English",
volume = "30",
pages = "1218--1226",
journal = "EUR J PREV CARDIOL",
issn = "2047-4873",
publisher = "SAGE Publications",
number = "12",

}

RIS

TY - JOUR

T1 - Biomarker-based prediction of fatal and non-fatal cardiovascular outcomes in individuals with diabetes mellitus

AU - Haller, Paul M

AU - Goßling, Alina

AU - Magnussen, Christina

AU - Brenner, Hermann

AU - Schöttker, Ben

AU - Iacoviello, Licia

AU - Costanzo, Simona

AU - Kee, Frank

AU - Koenig, Wolfgang

AU - Linneberg, Allan

AU - Sujana, Chaterina

AU - Thorand, Barbara

AU - Salomaa, Veikko

AU - Niiranen, Teemu J

AU - Söderberg, Stefan

AU - Völzke, Henry

AU - Dörr, Marcus

AU - Sans, Susana

AU - Padró, Teresa

AU - Felix, Stephan B

AU - Nauck, Matthias

AU - Petersmann, Astrid

AU - Palmieri, Luigi

AU - Donfrancesco, Chiara

AU - De Ponti, Roberto

AU - Veronesi, Giovanni

AU - Ferrario, Marco M

AU - Kuulasmaa, Kari

AU - Zeller, Tanja

AU - Ojeda, Francisco

AU - Blankenberg, Stefan

AU - Westermann, Dirk

AU - BiomarCaRE Consortium

N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2023/9/6

Y1 - 2023/9/6

N2 - AIMS: 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.METHODS AND RESULTS: We used individual-level data of 95 292 individuals of the European population harmonized in the Biomarker for Cardiovascular Risk Assessment across Europe 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 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, 6090 (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).CONCLUSION: 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.

AB - AIMS: 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.METHODS AND RESULTS: We used individual-level data of 95 292 individuals of the European population harmonized in the Biomarker for Cardiovascular Risk Assessment across Europe 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 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, 6090 (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).CONCLUSION: 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.

U2 - 10.1093/eurjpc/zwad122

DO - 10.1093/eurjpc/zwad122

M3 - SCORING: Journal article

C2 - 37079290

VL - 30

SP - 1218

EP - 1226

JO - EUR J PREV CARDIOL

JF - EUR J PREV CARDIOL

SN - 2047-4873

IS - 12

ER -