Contribution of 30 biomarkers to 10-year cardiovascular risk estimation in 2 population cohorts: the MONICA, risk, genetics, archiving, and monograph (MORGAM) biomarker project
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Contribution of 30 biomarkers to 10-year cardiovascular risk estimation in 2 population cohorts: the MONICA, risk, genetics, archiving, and monograph (MORGAM) biomarker project. / Blankenberg, Stefan; Zeller, Tanja; Saarela, Olli; Havulinna, Aki S; Kee, Frank; Tunstall-Pedoe, Hugh; Kuulasmaa, Kari; Yarnell, John; Schnabel, Renate B; Wild, Philipp S; Münzel, Thomas F; Lackner, Karl J; Tiret, Laurence; Evans, Alun; Salomaa, Veikko; MORGAM Project.
In: CIRCULATION, Vol. 121, No. 22, 08.06.2010, p. 2388-2397.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Contribution of 30 biomarkers to 10-year cardiovascular risk estimation in 2 population cohorts: the MONICA, risk, genetics, archiving, and monograph (MORGAM) biomarker project
AU - Blankenberg, Stefan
AU - Zeller, Tanja
AU - Saarela, Olli
AU - Havulinna, Aki S
AU - Kee, Frank
AU - Tunstall-Pedoe, Hugh
AU - Kuulasmaa, Kari
AU - Yarnell, John
AU - Schnabel, Renate B
AU - Wild, Philipp S
AU - Münzel, Thomas F
AU - Lackner, Karl J
AU - Tiret, Laurence
AU - Evans, Alun
AU - Salomaa, Veikko
AU - MORGAM Project
PY - 2010/6/8
Y1 - 2010/6/8
N2 - BACKGROUND: Cardiovascular risk estimation by novel biomarkers needs assessment in disease-free population cohorts, followed up for incident cardiovascular events, assaying the serum and plasma archived at baseline. We report results from 2 cohorts in such a continuing study.METHODS AND RESULTS: Thirty novel biomarkers from different pathophysiological pathways were evaluated in 7915 men and women of the FINRISK97 population cohort with 538 incident cardiovascular events at 10 years (fatal or nonfatal coronary or stroke events), from which a biomarker score was developed and then validated in the 2551 men of the Belfast Prospective Epidemiological Study of Myocardial Infarction (PRIME) cohort (260 events). No single biomarker consistently improved risk estimation in FINRISK97 men and FINRISK97 women and the Belfast PRIME Men cohort after allowing for confounding factors; however, the strongest associations (with hazard ratio per SD in FINRISK97 men) were found for N-terminal pro-brain natriuretic peptide (1.23), C-reactive protein (1.23), B-type natriuretic peptide (1.19), and sensitive troponin I (1.18). A biomarker score was developed from the FINRISK97 cohort with the use of regression coefficients and lasso methods, with selection of troponin I, C-reactive protein, and N-terminal pro-brain natriuretic peptide. Adding this score to a conventional risk factor model in the Belfast PRIME Men cohort validated it by improved c-statistics (P=0.004) and integrated discrimination (P<0.0001) and led to significant reclassification of individuals into risk categories (P=0.0008).CONCLUSIONS: The addition of a biomarker score including N-terminal pro-brain natriuretic peptide, C-reactive protein, and sensitive troponin I to a conventional risk model improved 10-year risk estimation for cardiovascular events in 2 middle-aged European populations. Further validation is needed in other populations and age groups.
AB - BACKGROUND: Cardiovascular risk estimation by novel biomarkers needs assessment in disease-free population cohorts, followed up for incident cardiovascular events, assaying the serum and plasma archived at baseline. We report results from 2 cohorts in such a continuing study.METHODS AND RESULTS: Thirty novel biomarkers from different pathophysiological pathways were evaluated in 7915 men and women of the FINRISK97 population cohort with 538 incident cardiovascular events at 10 years (fatal or nonfatal coronary or stroke events), from which a biomarker score was developed and then validated in the 2551 men of the Belfast Prospective Epidemiological Study of Myocardial Infarction (PRIME) cohort (260 events). No single biomarker consistently improved risk estimation in FINRISK97 men and FINRISK97 women and the Belfast PRIME Men cohort after allowing for confounding factors; however, the strongest associations (with hazard ratio per SD in FINRISK97 men) were found for N-terminal pro-brain natriuretic peptide (1.23), C-reactive protein (1.23), B-type natriuretic peptide (1.19), and sensitive troponin I (1.18). A biomarker score was developed from the FINRISK97 cohort with the use of regression coefficients and lasso methods, with selection of troponin I, C-reactive protein, and N-terminal pro-brain natriuretic peptide. Adding this score to a conventional risk factor model in the Belfast PRIME Men cohort validated it by improved c-statistics (P=0.004) and integrated discrimination (P<0.0001) and led to significant reclassification of individuals into risk categories (P=0.0008).CONCLUSIONS: The addition of a biomarker score including N-terminal pro-brain natriuretic peptide, C-reactive protein, and sensitive troponin I to a conventional risk model improved 10-year risk estimation for cardiovascular events in 2 middle-aged European populations. Further validation is needed in other populations and age groups.
KW - Adult
KW - Aged
KW - Biological Specimen Banks/standards
KW - Biomarkers/blood
KW - Cardiovascular Diseases/blood
KW - Cohort Studies
KW - Female
KW - Finland
KW - Follow-Up Studies
KW - Humans
KW - Internationality
KW - Male
KW - Middle Aged
KW - Northern Ireland
KW - Population Surveillance/methods
KW - Prospective Studies
KW - Risk Factors
KW - Statistics as Topic/methods
U2 - 10.1161/CIRCULATIONAHA.109.901413
DO - 10.1161/CIRCULATIONAHA.109.901413
M3 - SCORING: Journal article
C2 - 20497981
VL - 121
SP - 2388
EP - 2397
JO - CIRCULATION
JF - CIRCULATION
SN - 0009-7322
IS - 22
ER -
