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

TY - JOUR

T1 - Cardiovascular risk prediction in the general population with use of suPAR, CRP, and Framingham Risk Score

AU - Lyngbæk, Stig

AU - Marott, Jacob L

AU - Sehestedt, Thomas

AU - Hansen, Tine W

AU - Olsen, Michael H

AU - Andersen, Ove

AU - Linneberg, Allan

AU - Haugaard, Steen B

AU - Eugen-Olsen, Jesper

AU - Hansen, Peter R

AU - Jeppesen, Jørgen

N1 - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

PY - 2013/9

Y1 - 2013/9

N2 - 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 12.7years, 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, p20%) 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.

AB - 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 12.7years, 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, p20%) 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.

U2 - 10.1016/j.ijcard.2012.07.018

DO - 10.1016/j.ijcard.2012.07.018

M3 - Journal article

C2 - 22909410

SN - 0167-5273

VL - 167

SP - 2904

EP - 2911

JO - International Journal of Cardiology

JF - International Journal of Cardiology

IS - 6

ER -