Which biomarkers are predictive specifically for cardiovascular or for non-cardiovascular mortality in men? Evidence from the Caerphilly Prospective Study (CaPS)

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:201

Article

Patterson, Christopher C.¹  Blankenberg, Stefan²  Ben-Shlomo, Yoav³  Heslop, Luke⁴  Bayer, Antony⁴  Lowe, Gordon⁵  Zeller, Tanja²  Gallacher, John⁶  Young, Ian¹  Yarnell, John¹ 

[1] Queens Univ Belfast, Ctr Publ Hlth, Belfast BT12 6BJ, Antrim, North Ireland

[2] Univ Heart Ctr Hamburg, Clin Gen & Intervent Cardiol, Hamburg, Germany

[3] Univ Bristol, Social & Community Med, Bristol BS8 1TH, Avon, England

[4] Cardiff Univ, Sch Med, Inst Primary Care & Publ Hlth, Cardiff CF10 3AX, S Glam, Wales

[5] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland

[6] Warneford Hosp, Dept Psychiat, Oxford OX3 7JX, England

关键词: Biomarkers;    Cardiovascular mortality;    Non-cardiovascular mortality;    Epidemiology;   

DOI  :  10.1016/j.ijcard.2015.07.106

来源: Elsevier

【 摘 要 】

Objective: To examine a panel of 28 biomarkers for prediction of cardiovascular disease (CVD) and non-CVD mortality in a population-based cohort of men. Methods: Starting in 1979, middle-aged men in Caerphilly underwent detailed medical examination. Subsequently 2171 men were re-examined during 1989-1993, and fasting blood samples obtained from 1911 men (88%). Fibrinogen, viscosity and white cell count (WCC), routine biochemistry tests and lipids were analysed using fresh samples. Stored aliquots were later analysed for novel biomarkers. Statistical analysis of CVD and non-CVD mortality follow-up used competing risk Cox regression models with biomarkers in thirds tested at the 1% significance level after covariate adjustment. Results: During an average of 15.4 years follow-up, troponin (subhazard ratio per third 1.71, 95% CI 1.46-1.99) and B-natriuretic peptide (BNP) (subhazard ratio per third 1.54, 95% CI 1.34-1.78) showed strong trends with CVD death but not with non-CVD death. WCC and fibrinogen showed similar weaker findings. Plasma viscosity, growth differentiation factor 15 (GDF-15) and interleukin-6 (IL-6) were associated positively with both CVD death and non-CVD death while total cholesterol was associated positively with CVD death but negatively with non-CVD death. Creactive protein (C-RP), alkaline phosphatase, gamma-glutamyltransferase (GGT), retinol binding protein 4 (RBP-4) and vitamin B6 were significantly associated only with non-CVD death, the last two negatively. Troponin, BNP and IL-6 showed evidence of diminishing associations with CVD mortality through follow-up. Conclusion: Biomarkers for cardiac necrosis were strong, specific predictors of CVD mortality while many inflammatory markers were equally predictive of non-CVD mortality. (C) 2015 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY license

【 授权许可】

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