Abstract 17337: Multiple Biomarkers for the Prediction of Cardiovascular Death Within the Minnesota Heart Survey
Background: As understanding of pathophysiologic pathways for cardiovascular disease (CVD) improves, new biomarkers are emerging. We examined several novel biomarkers to determine their ability to predict CVD mortality in participants enrolled in the Minnesota Heart Survey (MHS), a population-based surveillance of CVD risk factors.
Methods: In a nested case-control study within MHS, seven biomarkers were assayed: high sensitivity cardiac troponin I (hs-cTnI, Singulex); cTnI (Ortho-Clinical Diagnostics); copeptin (BRAHMS); hs-CRP; NT-proBNP (Roche), MR-proANP (BRAHMS) and ST2 (Critical Diagnostics) in 211 cardiovascular deaths (cardiovascular heart disease, stroke, congestive heart failure) and 253 age, sex, and study year matched controls identified after 8 to 15 years of follow-up. Study subjects were predominantly of white race and average age 68 years. Logistic regression models evaluated the relations of biomarkers relative to the odds of CVD mortality, adjusted for age, race, sex, education, study year, smoking, body mass index, serum total cholesterol, systolic blood pressure, previous hospitalization for CVD event, and other significant biomarkers.
Results: Cases survived a median of 7.2 years after enrollment into MHS. Prevalence of concentrations of hsCRP > 3 mg/L (71% vs. 51%), increased NT-proBNP (19% vs. 4.3%), and hs-cTnI > 10.1 pg/mL (8.7% vs. 1.0%) were more common among cases than among controls (all p<0.001 in unadjusted analyses). The adjusted odds of dying from CVD were greater among cases compared to controls for increased hsCRP (OR 1.8, 95% CI 1.0, 3.3), NT-proBNP (OR 4.7, 95% CI 1.5, 14) and hs-cTnI (OR 6.5, 95% CI 1.1, 38).
Conclusion: Multiple biomarkers that are likely indicative of different underlying pathophysiologic mechanisms (NT-proBNP: myocardial dysfunction; hsCRP: systemic inflammation; hs-cTnI: myocardial damage) were independently associated with increased cardiovascular death in a community sample.
- © 2010 by American Heart Association, Inc.