Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy

Aim: The SCORE2 algorithm is recommended to estimate risk of cardiovascular disease (CVD). Coronary artery calcification (CAC) score is expensive but improves the risk prediction. This study aims to determine and compare the additive value of CAC-score and 19 biomarkers in risk prediction. Methods:...

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Main Authors: Mie Schæffer, Jeppe Holm Rasmussen, Maise Høigaard Fredgart, Selma Hasific, Frederikke Nørregaard Jakobsen, Flemming Hald Steffensen, Jess Lambrechtsen, Niels Peter Rønnow Sand, Lars Melholt Rasmussen, Axel CP. Diederichsen
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Atherosclerosis Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667089524000440
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author Mie Schæffer
Jeppe Holm Rasmussen
Maise Høigaard Fredgart
Selma Hasific
Frederikke Nørregaard Jakobsen
Flemming Hald Steffensen
Jess Lambrechtsen
Niels Peter Rønnow Sand
Lars Melholt Rasmussen
Axel CP. Diederichsen
author_facet Mie Schæffer
Jeppe Holm Rasmussen
Maise Høigaard Fredgart
Selma Hasific
Frederikke Nørregaard Jakobsen
Flemming Hald Steffensen
Jess Lambrechtsen
Niels Peter Rønnow Sand
Lars Melholt Rasmussen
Axel CP. Diederichsen
author_sort Mie Schæffer
collection DOAJ
description Aim: The SCORE2 algorithm is recommended to estimate risk of cardiovascular disease (CVD). Coronary artery calcification (CAC) score is expensive but improves the risk prediction. This study aims to determine and compare the additive value of CAC-score and 19 biomarkers in risk prediction. Methods: Traditional cardiovascular (CV) risk factors, CAC-score, and a wide range of biomarkers (including lipids, calcium-phosphate metabolism, troponin, inflammation, kidney function and ankle brachial index (ABI)) were collected from 1211 randomly selected middle-aged men and women in this multicenter prospective cohort in 2009–2010. 10-year follow-up data on CV-events were obtained via the Danish Health Registries. CV-event was defined as stroke, myocardial infarction, hospitalization for heart failure, coronary artery revascularization or death from CVD. The association between SCORE2, CAC-score, biomarkers, and CV-events was assessed using cox proportional hazard rates (HR) and compared using AUC-calculation of ROC-curves. Finally, net reclassification improvement (NRI) was calculated. Results: 92 participants had CV-events. Adjusted for risk factors, CAC-score was significantly associated with events (adjusted HR 1.9 (95%CI:1.1; 3.3), 3.6 (95%CI:1.9; 6.8), and 5. (95%CI:2.6; 10.3) for CAC-score 1–99, CAC-score 100–399 and CAC-score ≥400, respectively. HR for the highest quartile of CRP was 2.3 (95%CI:1.2; 4.5), while none of the remaining biomarkers improved HR. Adjusted for SCORE2, the CAC-score improved AUC (AUCCAC: 0.72, AUCSCORE2: 0.67, p<0.01). A combination of selected biomarkers (total cholesterol, low-density lipoprotein, phosphate, troponin, CRP, and creatinine) borderline improved AUC (AUCBiomarkers + SCORE2: 0.71, AUCSCORE2: 0.67, p=0.06). NRI for CAC score was 63 % (p<0.0001). Conclusion: CAC-score improved prediction of CV-events, however the selected biomarkers did not.
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spelling doaj-art-404a0c31e15e4256a126103e2bcfbfb12025-08-20T01:56:34ZengElsevierAtherosclerosis Plus2667-08952024-12-015891510.1016/j.athplu.2024.09.003Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudyMie Schæffer0Jeppe Holm Rasmussen1Maise Høigaard Fredgart2Selma Hasific3Frederikke Nørregaard Jakobsen4Flemming Hald Steffensen5Jess Lambrechtsen6Niels Peter Rønnow Sand7Lars Melholt Rasmussen8Axel CP. Diederichsen9Department of Cardiology, Odense University Hospital, Denmark; Corresponding author.Department of Cardiology, Odense University Hospital, DenmarkDepartment of Cardiology, Odense University Hospital, DenmarkDepartment of Cardiology, Odense University Hospital, DenmarkDepartment of Cardiology, Odense University Hospital, DenmarkDepartment of Cardiology, Sygehus Lillebælt Vejle, Vejle, DenmarkDepartment of Cardiology, Svendborg Hospital, Svendborg, DenmarkDepartment of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark; Department of Regional Health Research, University of Southern Denmark, Esbjerg, DenmarkCentre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Odense, Denmark; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark; Cardiovascular Centre of Excellence, University of Southern Denmark, Odense, DenmarkDepartment of Cardiology, Odense University Hospital, Denmark; Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Odense, Denmark; Cardiovascular Centre of Excellence, University of Southern Denmark, Odense, DenmarkAim: The SCORE2 algorithm is recommended to estimate risk of cardiovascular disease (CVD). Coronary artery calcification (CAC) score is expensive but improves the risk prediction. This study aims to determine and compare the additive value of CAC-score and 19 biomarkers in risk prediction. Methods: Traditional cardiovascular (CV) risk factors, CAC-score, and a wide range of biomarkers (including lipids, calcium-phosphate metabolism, troponin, inflammation, kidney function and ankle brachial index (ABI)) were collected from 1211 randomly selected middle-aged men and women in this multicenter prospective cohort in 2009–2010. 10-year follow-up data on CV-events were obtained via the Danish Health Registries. CV-event was defined as stroke, myocardial infarction, hospitalization for heart failure, coronary artery revascularization or death from CVD. The association between SCORE2, CAC-score, biomarkers, and CV-events was assessed using cox proportional hazard rates (HR) and compared using AUC-calculation of ROC-curves. Finally, net reclassification improvement (NRI) was calculated. Results: 92 participants had CV-events. Adjusted for risk factors, CAC-score was significantly associated with events (adjusted HR 1.9 (95%CI:1.1; 3.3), 3.6 (95%CI:1.9; 6.8), and 5. (95%CI:2.6; 10.3) for CAC-score 1–99, CAC-score 100–399 and CAC-score ≥400, respectively. HR for the highest quartile of CRP was 2.3 (95%CI:1.2; 4.5), while none of the remaining biomarkers improved HR. Adjusted for SCORE2, the CAC-score improved AUC (AUCCAC: 0.72, AUCSCORE2: 0.67, p<0.01). A combination of selected biomarkers (total cholesterol, low-density lipoprotein, phosphate, troponin, CRP, and creatinine) borderline improved AUC (AUCBiomarkers + SCORE2: 0.71, AUCSCORE2: 0.67, p=0.06). NRI for CAC score was 63 % (p<0.0001). Conclusion: CAC-score improved prediction of CV-events, however the selected biomarkers did not.http://www.sciencedirect.com/science/article/pii/S2667089524000440Coronary artery calcification scoreEuropean HeartScoreBiomarkersRisk assessmentRisk predictionCardiovascular disease
spellingShingle Mie Schæffer
Jeppe Holm Rasmussen
Maise Høigaard Fredgart
Selma Hasific
Frederikke Nørregaard Jakobsen
Flemming Hald Steffensen
Jess Lambrechtsen
Niels Peter Rønnow Sand
Lars Melholt Rasmussen
Axel CP. Diederichsen
Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy
Atherosclerosis Plus
Coronary artery calcification score
European HeartScore
Biomarkers
Risk assessment
Risk prediction
Cardiovascular disease
title Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy
title_full Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy
title_fullStr Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy
title_full_unstemmed Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy
title_short Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy
title_sort coronary artery calcification score and 19 biomarkers on cardiovascular events a 10 year follow up danrisk substudy
topic Coronary artery calcification score
European HeartScore
Biomarkers
Risk assessment
Risk prediction
Cardiovascular disease
url http://www.sciencedirect.com/science/article/pii/S2667089524000440
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