Abstract | BACKGROUND: We investigated multiple biomarkers of various pathophysiologic pathways to determine their relationships with adverse outcomes in patients presenting with symptoms of acute coronary syndrome. METHODS: RESULTS: Patients with increased PlGF, NT-proBNP, hsCRP, or cTnI or decreased eGFR had 11% to 20% higher all-cause mortality rates than patients with concentrations within reference intervals: 20.4% (eGFR), 16.0% (PlGF), 15.8% ( hsCRP), 12.7% ( NT-proBNP), and 11.3% (cTnI; all P < or = 0.03). No differences in mortality rates were observed between those with increased vs normal concentrations of MPO, CD40L, or MMP-9. Decreased eGFR (RR 3.4, P = 0.004) and increased NT-proBNP (RR 7.9, P = 0.04) were independently predictive of mortality, and PlGF (RR 2.0, P = 0.08) approached significance. Patients with increased NT-proBNP (12.3%) or cTnI (33.8%) had higher cardiac event rates (each P <0.02), with increased MPO (11.1%) showing a trend (P = 0.09). Patients in whom both cTnI and MPO were increased had a cardiac event rate of 43%. CONCLUSION: Multiple biomarkers that are likely indicative of different underlying pathophysiologic mechanisms are independently predictive of increased risk for adverse events in patients with acute coronary syndrome.
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Authors | Fred S Apple, Lesly A Pearce, Adrine Chung, Ranka Ler, MaryAnn M Murakami |
Journal | Clinical chemistry
(Clin Chem)
Vol. 53
Issue 5
Pg. 874-81
(May 2007)
ISSN: 0009-9147 [Print] England |
PMID | 17384009
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Acute Disease
- Biomarkers
(blood)
- Coronary Disease
(diagnosis, mortality, therapy)
- Endpoint Determination
- Glomerular Filtration Rate
- Humans
- Kaplan-Meier Estimate
- Myocardial Infarction
(diagnosis, mortality, therapy)
- Prognosis
- Proportional Hazards Models
- Risk
- Syndrome
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