Sex-specific added value of cardiac biomarkers for 10-year cardiovascular risk prediction.

Abstract

AIMS:

To evaluate the sex-specific predictive value of N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin T (hs-cTnT) and creatine kinase myocardial band (CK-MB) for 10-year risk prediction of coronary heart disease (CHD), stroke, heart failure (HF) and composite outcomes.

METHODS:

Five-thousand four-hundred thirty individuals (mean age 68.6 years, 59.9% women) from the Rotterdam Study, with biomarker measurements between 1997 and 2001, were included. Participants were followed until 2015. We fitted 'basic' models using traditional cardiovascular risk factors. Improvements in c-statistics and net reclassification improvement (NRI) for events and non-events were calculated.

RESULTS:

During a median follow-up of 14 years, 747 (13.8%), 563 (10.4%), and 664 (12.2%) participants were diagnosed with CHD, stroke, and HF, respectively. NT-proBNP improved the discriminative performance of the 'basic' model for all endpoints (c-statistic improvements ranging from 0.007 to 0.050) and provided significant event-NRI for HF (14.3% in women; 10.7% in men) and for stroke in men (9.3%). The addition of hs-cTnT increased c-statistic for CHD in women by 0.029 (95% CI, 0.011-0.047) and for HF in men by 0.034 (95% CI, 0.014-0.053), and provided significant event-NRI for CHD (10.3%) and HF (7.8%) in women, and for stroke (8.4%) in men. The added predictive value of CK-MB was limited.

CONCLUSION:

NT-proBNP and hs-cTnT provided added predictive value for various cardiovascular outcomes above traditional risk factors. Sex differences were observed in the predictive performance of these biomarkers.

• Authors: Fang Zhu, Banafsheh Arshi, Maarten J G Leening, Elif Aribas, M Arfan Ikram, Eric Boersma, M Kamran Ikram, Maryam Kavousi
• Journal: European journal of preventive cardiology (Eur J Prev Cardiol) Vol. 29 Issue 11 Pg. 1559-1567 (08 22 2022) ISSN: 2047-4881 [Electronic] England
• PMID: 35512434 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.

Chemical References

• Biomarkers
• Natriuretic Peptide, Brain
• Peptide Fragments
• Troponin T

Topics

• Humans
• Male
• Female
• Aged
• Risk Factors
• Cardiovascular Diseases (diagnosis, epidemiology)
• Biomarkers
• Heart Failure
• Coronary Disease (diagnosis, epidemiology)
• Stroke (diagnosis, epidemiology)
• Heart Disease Risk Factors
• Natriuretic Peptide, Brain
• Peptide Fragments
• Troponin T