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Cardiovascular risk prediction in the general population with use of suPAR, CRP, and Framingham Risk Score.

Abstract：

BACKGROUND:The inflammatory biomarkers soluble urokinase plasminogen activator receptor (suPAR) and C-reactive protein (CRP) independently predict cardiovascular disease (CVD). The prognostic implications of suPAR and CRP combined with Framingham Risk Score (FRS) have not been determined. METHODS:From 1993 to 1994, baseline levels of suPAR and CRP were obtained from 2315 generally healthy Danish individuals (mean [SD] age: 53.9 [10.6] years) who were followed for the composite outcome of ischemic heart disease, stroke and CVD mortality. RESULTS:During a median follow-up of 12.7 years, 302 events were recorded. After adjusting for FRS, women with suPAR levels in the highest tertile had a 1.74-fold (95% confidence interval [CI]: 1.08-2.81, p=0.027) and men a 2.09-fold (95% CI: 1.37-3.18, p<0.001) increase in risk compared to the lowest tertile. Including suPAR and CRP together resulted in stronger risk prediction with a 3.30-fold (95% CI: 1.36-7.99, p<0.01) increase for women and a 3.53-fold (1.78-7.02, p<0.001) increase for men when both biomarkers were in the highest compared to the lowest tertile. The combined extreme tertiles of suPAR and CRP reallocated individuals predicted to an intermediate 10-year risk of CVD of 10-20% based on FRS, to low (<10%) or high (>20%) risk categories, respectively. This was reflected in a significant improvement of C statistics for men (p=0.034) and borderline significant for women (p=0.054), while the integrated discrimination improvement was highly significant (P≤0.001) for both genders. CONCLUSIONS:suPAR provides prognostic information of CVD risk beyond FRS and improves risk prediction substantially when combined with CRP in this setting.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Lyngbæk S,Marott JL,Sehestedt T,Hansen TW,Olsen MH,Andersen O,Linneberg A,Haugaard SB,Eugen-Olsen J,Hansen PR,Jeppesen J

doi

10.1016/j.ijcard.2012.07.018

subject

Has Abstract

pub_date

2013-09-10 00:00:00

pages

2904-11

issue

6

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(12)00970-9

journal_volume

167

pub_type

杂志文章

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