New risk markers may change the HeartScore risk classification significantly in one-fifth of the population

M H Olsen; T W Hansen; M K Christensen; F Gustafsson; S Rasmussen; K Wachtell; H Ibsen; C Torp-Pedersen; P R Hildebrandt; M H Olsen; T W Hansen; M K Christensen; F Gustafsson; S Rasmussen; K Wachtell; H Ibsen; C Torp-Pedersen; P R Hildebrandt

doi:10.1038/jhh.2008.112

New risk markers may change the HeartScore risk classification significantly in one-fifth of the population

M H Olsen, T W Hansen, M K Christensen, F Gustafsson, S Rasmussen, K Wachtell, H Ibsen, C Torp-Pedersen, P R Hildebrandt, M H Olsen, T W Hansen, M K Christensen, F Gustafsson, S Rasmussen, K Wachtell, H Ibsen, C Torp-Pedersen, P R Hildebrandt

11 Citations (Scopus)

Abstract

The study aim was to determine whether urine albumin/creatinine ratio (UACR), high-sensitivity C-reactive protein (hsCRP) or N-terminal pro-brain natriuretic peptide (Nt-proBNP) added to risk prediction based on HeartScore and history of diabetes or cardiovascular disease. A Danish population sample of 2460 individuals was divided in three groups: 472 subjects receiving cardiovascular medication or having history of diabetes, prior myocardial infarction or stroke, 559 high-risk subjects with a 10-year risk of cardiovascular death above 5% as estimated by HeartScore, and 1429 low-moderate risk subjects with estimated risk below 5%. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (CEP) occurred in 204 subjects. CEP was predicted in all three groups by UACR (HRs: 2.1, 2.1 and 2.3 per 10-fold increase, all P<0.001) or by hsCRP (HRs: 1.9, 1.9 and 1.7 per 10-fold increase, all P<0.05), but not by Nt-proBNP (HRs: 1.1, 2.6 and 3.7 per 10-fold increase, last two P<0.001) (P<0.05 for interaction). In the low-moderate risk group, pre-specified gender adjusted (men/women) cutoff values of UACR> or =0.73/1.06 mg mmol(-1) or hsCRP> or =6.0/7.3 mg l(-1) identified a subgroup of 16% who experienced one-third of the CEPs. In the patient group, combined absence of high UACR and high Nt-proBNP> or =110/164 pg ml(-1) (men/women) identified a subgroup of 52% who experienced only 15% of the CEPs. Additional use of UACR and hsCRP in subjects with low-moderate risk and UACR and Nt-proBNP in subjects with known diabetes of cardiovascular disease changed HeartScore risk classification significantly in 19% of the population.

Original language	English
Journal	Journal of Human Hypertension
Volume	23
Issue number	2
Pages (from-to)	105-12
Number of pages	7
ISSN	0950-9240
DOIs	https://doi.org/10.1038/jhh.2008.112 https://doi.org/10.1038/jhh.2008.112
Publication status	Published - 2008

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Olsen, M. H., Hansen, T. W., Christensen, M. K., Gustafsson, F., Rasmussen, S., Wachtell, K., Ibsen, H., Torp-Pedersen, C., Hildebrandt, P. R., Olsen, M. H., Hansen, T. W., Christensen, M. K., Gustafsson, F., Rasmussen, S., Wachtell, K., Ibsen, H., Torp-Pedersen, C., & Hildebrandt, P. R. (2008). New risk markers may change the HeartScore risk classification significantly in one-fifth of the population. Journal of Human Hypertension, 23(2), 105-12. https://doi.org/10.1038/jhh.2008.112, https://doi.org/10.1038/jhh.2008.112

Olsen, MH, Hansen, TW, Christensen, MK, Gustafsson, F, Rasmussen, S, Wachtell, K, Ibsen, H, Torp-Pedersen, C, Hildebrandt, PR, Olsen, MH, Hansen, TW, Christensen, MK, Gustafsson, F, Rasmussen, S, Wachtell, K, Ibsen, H, Torp-Pedersen, C & Hildebrandt, PR 2008, 'New risk markers may change the HeartScore risk classification significantly in one-fifth of the population', Journal of Human Hypertension, vol. 23, no. 2, pp. 105-12. https://doi.org/10.1038/jhh.2008.112, https://doi.org/10.1038/jhh.2008.112

@article{2748def064cb11df928f000ea68e967b,

title = "New risk markers may change the HeartScore risk classification significantly in one-fifth of the population",

abstract = "The study aim was to determine whether urine albumin/creatinine ratio (UACR), high-sensitivity C-reactive protein (hsCRP) or N-terminal pro-brain natriuretic peptide (Nt-proBNP) added to risk prediction based on HeartScore and history of diabetes or cardiovascular disease. A Danish population sample of 2460 individuals was divided in three groups: 472 subjects receiving cardiovascular medication or having history of diabetes, prior myocardial infarction or stroke, 559 high-risk subjects with a 10-year risk of cardiovascular death above 5% as estimated by HeartScore, and 1429 low-moderate risk subjects with estimated risk below 5%. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (CEP) occurred in 204 subjects. CEP was predicted in all three groups by UACR (HRs: 2.1, 2.1 and 2.3 per 10-fold increase, all P<0.001) or by hsCRP (HRs: 1.9, 1.9 and 1.7 per 10-fold increase, all P<0.05), but not by Nt-proBNP (HRs: 1.1, 2.6 and 3.7 per 10-fold increase, last two P<0.001) (P<0.05 for interaction). In the low-moderate risk group, pre-specified gender adjusted (men/women) cutoff values of UACR> or =0.73/1.06 mg mmol(-1) or hsCRP> or =6.0/7.3 mg l(-1) identified a subgroup of 16% who experienced one-third of the CEPs. In the patient group, combined absence of high UACR and high Nt-proBNP> or =110/164 pg ml(-1) (men/women) identified a subgroup of 52% who experienced only 15% of the CEPs. Additional use of UACR and hsCRP in subjects with low-moderate risk and UACR and Nt-proBNP in subjects with known diabetes of cardiovascular disease changed HeartScore risk classification significantly in 19% of the population.",

author = "Olsen, {M H} and Hansen, {T W} and Christensen, {M K} and F Gustafsson and S Rasmussen and K Wachtell and H Ibsen and C Torp-Pedersen and Hildebrandt, {P R} and Olsen, {M H} and Hansen, {T W} and Christensen, {M K} and F Gustafsson and S Rasmussen and K Wachtell and H Ibsen and C Torp-Pedersen and Hildebrandt, {P R}",

note = "Keywords: Adult; Albuminuria; Biological Markers; C-Reactive Protein; Cardiovascular Diseases; Creatine; Female; Health Status Indicators; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Risk Assessment",

year = "2008",

doi = "10.1038/jhh.2008.112",

language = "English",

volume = "23",

pages = "105--12",

journal = "Journal of Human Hypertension",

issn = "0950-9240",

publisher = "nature publishing group",

number = "2",

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TY - JOUR

T1 - New risk markers may change the HeartScore risk classification significantly in one-fifth of the population

AU - Olsen, M H

AU - Hansen, T W

AU - Christensen, M K

AU - Gustafsson, F

AU - Rasmussen, S

AU - Wachtell, K

AU - Ibsen, H

AU - Torp-Pedersen, C

AU - Hildebrandt, P R

AU - Olsen, M H

AU - Hansen, T W

AU - Christensen, M K

AU - Gustafsson, F

AU - Rasmussen, S

AU - Wachtell, K

AU - Ibsen, H

AU - Torp-Pedersen, C

AU - Hildebrandt, P R

N1 - Keywords: Adult; Albuminuria; Biological Markers; C-Reactive Protein; Cardiovascular Diseases; Creatine; Female; Health Status Indicators; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Risk Assessment

PY - 2008

Y1 - 2008

N2 - The study aim was to determine whether urine albumin/creatinine ratio (UACR), high-sensitivity C-reactive protein (hsCRP) or N-terminal pro-brain natriuretic peptide (Nt-proBNP) added to risk prediction based on HeartScore and history of diabetes or cardiovascular disease. A Danish population sample of 2460 individuals was divided in three groups: 472 subjects receiving cardiovascular medication or having history of diabetes, prior myocardial infarction or stroke, 559 high-risk subjects with a 10-year risk of cardiovascular death above 5% as estimated by HeartScore, and 1429 low-moderate risk subjects with estimated risk below 5%. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (CEP) occurred in 204 subjects. CEP was predicted in all three groups by UACR (HRs: 2.1, 2.1 and 2.3 per 10-fold increase, all P<0.001) or by hsCRP (HRs: 1.9, 1.9 and 1.7 per 10-fold increase, all P<0.05), but not by Nt-proBNP (HRs: 1.1, 2.6 and 3.7 per 10-fold increase, last two P<0.001) (P<0.05 for interaction). In the low-moderate risk group, pre-specified gender adjusted (men/women) cutoff values of UACR> or =0.73/1.06 mg mmol(-1) or hsCRP> or =6.0/7.3 mg l(-1) identified a subgroup of 16% who experienced one-third of the CEPs. In the patient group, combined absence of high UACR and high Nt-proBNP> or =110/164 pg ml(-1) (men/women) identified a subgroup of 52% who experienced only 15% of the CEPs. Additional use of UACR and hsCRP in subjects with low-moderate risk and UACR and Nt-proBNP in subjects with known diabetes of cardiovascular disease changed HeartScore risk classification significantly in 19% of the population.

AB - The study aim was to determine whether urine albumin/creatinine ratio (UACR), high-sensitivity C-reactive protein (hsCRP) or N-terminal pro-brain natriuretic peptide (Nt-proBNP) added to risk prediction based on HeartScore and history of diabetes or cardiovascular disease. A Danish population sample of 2460 individuals was divided in three groups: 472 subjects receiving cardiovascular medication or having history of diabetes, prior myocardial infarction or stroke, 559 high-risk subjects with a 10-year risk of cardiovascular death above 5% as estimated by HeartScore, and 1429 low-moderate risk subjects with estimated risk below 5%. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (CEP) occurred in 204 subjects. CEP was predicted in all three groups by UACR (HRs: 2.1, 2.1 and 2.3 per 10-fold increase, all P<0.001) or by hsCRP (HRs: 1.9, 1.9 and 1.7 per 10-fold increase, all P<0.05), but not by Nt-proBNP (HRs: 1.1, 2.6 and 3.7 per 10-fold increase, last two P<0.001) (P<0.05 for interaction). In the low-moderate risk group, pre-specified gender adjusted (men/women) cutoff values of UACR> or =0.73/1.06 mg mmol(-1) or hsCRP> or =6.0/7.3 mg l(-1) identified a subgroup of 16% who experienced one-third of the CEPs. In the patient group, combined absence of high UACR and high Nt-proBNP> or =110/164 pg ml(-1) (men/women) identified a subgroup of 52% who experienced only 15% of the CEPs. Additional use of UACR and hsCRP in subjects with low-moderate risk and UACR and Nt-proBNP in subjects with known diabetes of cardiovascular disease changed HeartScore risk classification significantly in 19% of the population.

U2 - 10.1038/jhh.2008.112

DO - 10.1038/jhh.2008.112

M3 - Journal article

C2 - 18784734

SN - 0950-9240

VL - 23

SP - 105

EP - 112

JO - Journal of Human Hypertension

JF - Journal of Human Hypertension

IS - 2

ER -

New risk markers may change the HeartScore risk classification significantly in one-fifth of the population

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