Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial

Objective To assess if 12 novel circulating biomarkers, when added to ‘standard predictors’ available in general practice, could improve the 10-year prediction of cardiovascular events and mortality in patients with stable coronary heart disease.Design The patients participated as placebo receiving...

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Main Authors: Per Winkel, Janus Christian Jakobsen, Jørgen Hilden, Erik Kjøller, Ahmad Sajadieh, Jens Kastrup, Hans Jørn Kolmos, Anders Larsson, Johan Ärnlöv, Christian Gluud, Kasper Karmark Iversen, Gorm Boje Jensen, Mette Bjerre
Format: Article
Language:English
Published: BMJ Publishing Group 2020-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/8/e033720.full
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author Per Winkel
Janus Christian Jakobsen
Jørgen Hilden
Erik Kjøller
Ahmad Sajadieh
Jens Kastrup
Hans Jørn Kolmos
Anders Larsson
Johan Ärnlöv
Christian Gluud
Kasper Karmark Iversen
Gorm Boje Jensen
Mette Bjerre
author_facet Per Winkel
Janus Christian Jakobsen
Jørgen Hilden
Erik Kjøller
Ahmad Sajadieh
Jens Kastrup
Hans Jørn Kolmos
Anders Larsson
Johan Ärnlöv
Christian Gluud
Kasper Karmark Iversen
Gorm Boje Jensen
Mette Bjerre
author_sort Per Winkel
collection DOAJ
description Objective To assess if 12 novel circulating biomarkers, when added to ‘standard predictors’ available in general practice, could improve the 10-year prediction of cardiovascular events and mortality in patients with stable coronary heart disease.Design The patients participated as placebo receiving patients in the randomised clarithromycin for patients with stable coronary artery disease (CLARICOR) trial at a random time in their disease trajectory.Setting Five Copenhagen University cardiology departments and a coordinating centre.Participants 1998 participants with stable coronary artery disease.Outcomes Death and composite of myocardial infarction, unstable angina pectoris, cerebrovascular disease and death.Results When only ‘standard predictors’ were included, 83.4% of all-cause death predictions and 68.4% of composite outcome predictions were correct. Log(calprotectin) and log(cathepsin-S) were not associated (p≥0.01) with the outcomes, not even as single predictors. Adding the remaining 10 biomarkers (high-sensitive assay cardiac troponin T; neutrophil gelatinase-associated lipocalin; osteoprotegerin; N-terminal pro-B-type natriuretic peptide; tumour necrosis factor receptor 1 and 2; pregnancy-associated plasma protein A; endostatin; YKL40; cathepsin-B), which were all individually significantly associated with the prediction of the two outcomes, increased the figures to 84.7% and 69.7%.Conclusion When ‘standard predictors’ routinely available in general practices are used for risk assessment in consecutively sampled patients with stable coronary artery disease, the addition of 10 novel biomarkers to the prediction model improved the correct prediction of all-cause death and the composite outcome by <1.5%.Trial registration number NCT00121550.
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spelling doaj-art-6b24de0522e94d5a897eb0bdd7ac05922024-12-01T23:50:09ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2019-033720Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trialPer Winkel0Janus Christian Jakobsen1Jørgen Hilden2Erik Kjøller3Ahmad Sajadieh4Jens Kastrup5Hans Jørn Kolmos6Anders Larsson7Johan Ärnlöv8Christian Gluud9Kasper Karmark Iversen10Gorm Boje Jensen11Mette Bjerre121 Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkCardiology Department, Holbaek Hospital, Holbaek, DenmarkSection of Biostatistics, Department of Public Health Research, University of Copenhagen, Copenhagen, DenmarkCardiology, Herlev and Gentofte Hospital, Herlev, DenmarkDepartment of Cardiology, Copenhagen University Hospital Bispebjerg, Copenhagen NV, Denmark5 Cardiology Stem Cell Centre, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Clinical Microbiology, Odense University Hospital, Copenhagen, Denmark4Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University, Uppsala, SwedenFamily Medicine and Primary Care, Karolinska Universitetssjukhuset, Stockholm, SwedenThe Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, DenmarkThe Medical Research Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkObjective To assess if 12 novel circulating biomarkers, when added to ‘standard predictors’ available in general practice, could improve the 10-year prediction of cardiovascular events and mortality in patients with stable coronary heart disease.Design The patients participated as placebo receiving patients in the randomised clarithromycin for patients with stable coronary artery disease (CLARICOR) trial at a random time in their disease trajectory.Setting Five Copenhagen University cardiology departments and a coordinating centre.Participants 1998 participants with stable coronary artery disease.Outcomes Death and composite of myocardial infarction, unstable angina pectoris, cerebrovascular disease and death.Results When only ‘standard predictors’ were included, 83.4% of all-cause death predictions and 68.4% of composite outcome predictions were correct. Log(calprotectin) and log(cathepsin-S) were not associated (p≥0.01) with the outcomes, not even as single predictors. Adding the remaining 10 biomarkers (high-sensitive assay cardiac troponin T; neutrophil gelatinase-associated lipocalin; osteoprotegerin; N-terminal pro-B-type natriuretic peptide; tumour necrosis factor receptor 1 and 2; pregnancy-associated plasma protein A; endostatin; YKL40; cathepsin-B), which were all individually significantly associated with the prediction of the two outcomes, increased the figures to 84.7% and 69.7%.Conclusion When ‘standard predictors’ routinely available in general practices are used for risk assessment in consecutively sampled patients with stable coronary artery disease, the addition of 10 novel biomarkers to the prediction model improved the correct prediction of all-cause death and the composite outcome by <1.5%.Trial registration number NCT00121550.https://bmjopen.bmj.com/content/10/8/e033720.full
spellingShingle Per Winkel
Janus Christian Jakobsen
Jørgen Hilden
Erik Kjøller
Ahmad Sajadieh
Jens Kastrup
Hans Jørn Kolmos
Anders Larsson
Johan Ärnlöv
Christian Gluud
Kasper Karmark Iversen
Gorm Boje Jensen
Mette Bjerre
Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
BMJ Open
title Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
title_full Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
title_fullStr Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
title_full_unstemmed Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
title_short Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
title_sort prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease a 10 year follow up of the placebo group of the copenhagen claricor trial
url https://bmjopen.bmj.com/content/10/8/e033720.full
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