Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults
Background Current strategies for cardiovascular disease (CVD) risk assessment focus on 10‐year or longer timeframes. Shorter‐term CVD risk is also clinically relevant, particularly for high‐risk occupations, but is under‐investigated. Methods and Results We pooled data from participants in the ARIC...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.015410 |
| _version_ | 1818328008603205632 |
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| author | Maria Odette Gore Colby R. Ayers Amit Khera Christopher R. deFilippi Thomas J. Wang Stephen L. Seliger Vijay Nambi Elizabeth Selvin Jarett D. Berry W. Gregory Hundley Matthew Budoff Philip Greenland Mark H. Drazner Christie M. Ballantyne Benjamin D. Levine James A. de Lemos |
| author_facet | Maria Odette Gore Colby R. Ayers Amit Khera Christopher R. deFilippi Thomas J. Wang Stephen L. Seliger Vijay Nambi Elizabeth Selvin Jarett D. Berry W. Gregory Hundley Matthew Budoff Philip Greenland Mark H. Drazner Christie M. Ballantyne Benjamin D. Levine James A. de Lemos |
| author_sort | Maria Odette Gore |
| collection | DOAJ |
| description | Background Current strategies for cardiovascular disease (CVD) risk assessment focus on 10‐year or longer timeframes. Shorter‐term CVD risk is also clinically relevant, particularly for high‐risk occupations, but is under‐investigated. Methods and Results We pooled data from participants in the ARIC (Atherosclerosis Risk in Communities study), MESA (Multi‐Ethnic Study of Atherosclerosis), and DHS (Dallas Heart Study), free from CVD at baseline (N=16 581). Measurements included N‐terminal pro‐B‐type natriuretic peptide (>100 pg/mL prospectively defined as abnormal); high‐sensitivity cardiac troponin T (abnormal >5 ng/L); high‐sensitivity C‐reactive protein (abnormal >3 mg/L); left ventricular hypertrophy by ECG (abnormal if present); carotid intima‐media thickness, and plaque (abnormal >75th percentile for age and sex or presence of plaque); and coronary artery calcium (abnormal >10 Agatston U). Each abnormal test result except left ventricular hypertrophy by ECG was independently associated with increased 3‐year risk of global CVD (myocardial infarction, stroke, coronary revascularization, incident heart failure, or atrial fibrillation), even after adjustment for traditional CVD risk factors and the other test results. When a simple integer score counting the number of abnormal tests was used, 3‐year multivariable‐adjusted global CVD risk was increased among participants with integer scores of 1, 2, 3, and 4, by ≈2‐, 3‐, 4.5‐ and 8‐fold, respectively, when compared with those with a score of 0. Qualitatively similar results were obtained for atherosclerotic CVD (fatal or non‐fatal myocardial infarction or stroke). Conclusions A strategy incorporating multiple biomarkers and atherosclerosis imaging improved assessment of 3‐year global and atherosclerotic CVD risk compared with a standard approach using traditional risk factors. |
| first_indexed | 2024-12-13T12:25:20Z |
| format | Article |
| id | doaj.art-bc8faa8fe7cd4f5fa246c3b47e0c6c65 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T12:25:20Z |
| publishDate | 2020-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-bc8faa8fe7cd4f5fa246c3b47e0c6c652022-12-21T23:46:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-08-0191510.1161/JAHA.119.015410Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy AdultsMaria Odette Gore0Colby R. Ayers1Amit Khera2Christopher R. deFilippi3Thomas J. Wang4Stephen L. Seliger5Vijay Nambi6Elizabeth Selvin7Jarett D. Berry8W. Gregory Hundley9Matthew Budoff10Philip Greenland11Mark H. Drazner12Christie M. Ballantyne13Benjamin D. Levine14James A. de Lemos15Department of Medicine University of Colorado Anschutz Medical Campus Aurora CODepartment of Medicine University of Texas Southwestern Medical Center Dallas TXDepartment of Medicine University of Texas Southwestern Medical Center Dallas TXInova Heart and Vascular Institute Fall Church VADepartment of Medicine University of Texas Southwestern Medical Center Dallas TXDepartment of Medicine University of Maryland School of Medicine Baltimore MDDepartment of Medicine Baylor College of Medicine Houston TXDepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MDDepartment of Medicine University of Texas Southwestern Medical Center Dallas TXDepartments of Medicine and Radiological Sciences Wake Forest Health Sciences Winston‐Salem NCLos Angeles Biomedical Research Institute Los Angeles CADepartment of Preventive Medicine Feinberg School of Medicine, Northwestern University Chicago ILDepartment of Medicine University of Texas Southwestern Medical Center Dallas TXDepartment of Medicine Baylor College of Medicine Houston TXDepartment of Medicine University of Texas Southwestern Medical Center Dallas TXDepartment of Medicine University of Texas Southwestern Medical Center Dallas TXBackground Current strategies for cardiovascular disease (CVD) risk assessment focus on 10‐year or longer timeframes. Shorter‐term CVD risk is also clinically relevant, particularly for high‐risk occupations, but is under‐investigated. Methods and Results We pooled data from participants in the ARIC (Atherosclerosis Risk in Communities study), MESA (Multi‐Ethnic Study of Atherosclerosis), and DHS (Dallas Heart Study), free from CVD at baseline (N=16 581). Measurements included N‐terminal pro‐B‐type natriuretic peptide (>100 pg/mL prospectively defined as abnormal); high‐sensitivity cardiac troponin T (abnormal >5 ng/L); high‐sensitivity C‐reactive protein (abnormal >3 mg/L); left ventricular hypertrophy by ECG (abnormal if present); carotid intima‐media thickness, and plaque (abnormal >75th percentile for age and sex or presence of plaque); and coronary artery calcium (abnormal >10 Agatston U). Each abnormal test result except left ventricular hypertrophy by ECG was independently associated with increased 3‐year risk of global CVD (myocardial infarction, stroke, coronary revascularization, incident heart failure, or atrial fibrillation), even after adjustment for traditional CVD risk factors and the other test results. When a simple integer score counting the number of abnormal tests was used, 3‐year multivariable‐adjusted global CVD risk was increased among participants with integer scores of 1, 2, 3, and 4, by ≈2‐, 3‐, 4.5‐ and 8‐fold, respectively, when compared with those with a score of 0. Qualitatively similar results were obtained for atherosclerotic CVD (fatal or non‐fatal myocardial infarction or stroke). Conclusions A strategy incorporating multiple biomarkers and atherosclerosis imaging improved assessment of 3‐year global and atherosclerotic CVD risk compared with a standard approach using traditional risk factors.https://www.ahajournals.org/doi/10.1161/JAHA.119.015410carotid intima‐media thicknesscoronary artery calciumhigh‐sensitivity cardiac troponin Thigh‐sensitivity C‐reactive proteinN‐terminal pro B‐type natriuretic peptideplaque |
| spellingShingle | Maria Odette Gore Colby R. Ayers Amit Khera Christopher R. deFilippi Thomas J. Wang Stephen L. Seliger Vijay Nambi Elizabeth Selvin Jarett D. Berry W. Gregory Hundley Matthew Budoff Philip Greenland Mark H. Drazner Christie M. Ballantyne Benjamin D. Levine James A. de Lemos Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease carotid intima‐media thickness coronary artery calcium high‐sensitivity cardiac troponin T high‐sensitivity C‐reactive protein N‐terminal pro B‐type natriuretic peptide plaque |
| title | Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults |
| title_full | Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults |
| title_fullStr | Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults |
| title_full_unstemmed | Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults |
| title_short | Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults |
| title_sort | combining biomarkers and imaging for short term assessment of cardiovascular disease risk in apparently healthy adults |
| topic | carotid intima‐media thickness coronary artery calcium high‐sensitivity cardiac troponin T high‐sensitivity C‐reactive protein N‐terminal pro B‐type natriuretic peptide plaque |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.015410 |
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