دورية أكاديمية
أعرض في EDS

A comparative study of biomarkers for risk prediction in acute coronary syndrome-Results of the SIESTA (Systemic Inflammation Evaluation in non-ST-elevation Acute coronary syndrome) study.

التفاصيل البيبلوغرافية
العنوان: A comparative study of biomarkers for risk prediction in acute coronary syndrome-Results of the SIESTA (Systemic Inflammation Evaluation in non-ST-elevation Acute coronary syndrome) study.
المؤلفون: Kaski JC; Cardiovascular Biology Research Centre, Division of Cardiac and Vascular Sciences, St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK. j.kaski@sghms.ac.uk, Fernández-Bergés DJ, Consuegra-Sánchez L, Fernández JM, García-Moll X, Mostaza JM, Cebada RT, Juanatey JR, Martínez GG, Marrugat J
المصدر: Atherosclerosis [Atherosclerosis] 2010 Oct; Vol. 212 (2), pp. 636-43. Date of Electronic Publication: 2010 Jun 19.
نوع المنشور: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Ireland NLM ID: 0242543 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1484 (Electronic) Linking ISSN: 00219150 NLM ISO Abbreviation: Atherosclerosis Subsets: MEDLINE
أسماء مطبوعة: Publication: Limerick : Elsevier
Original Publication: Amsterdam, Elsevier.
مواضيع طبية MeSH: Acute Coronary Syndrome/*blood , Biomarkers/*metabolism, Aged ; Angina, Unstable/pathology ; Area Under Curve ; Cardiovascular Diseases/metabolism ; Female ; Humans ; Inflammation ; Macrophages/metabolism ; Male ; Middle Aged ; Myocardial Infarction/metabolism ; Natriuretic Peptide, Brain/chemistry ; Proportional Hazards Models ; Protein Structure, Tertiary ; T-Lymphocytes/metabolism ; Time Factors
مستخلص: Objective: We compared the 1-year predictive value of several inflammatory and non-inflammatory biomarkers in ACS patients.
Methods: In 610 patients (73.0% male)--36.0% unstable angina (UA) and 64.0% NSTEMI--we assessed high-sensitivity C-reactive protein (hs-CRP), interleukins 6, 10 and 18, soluble CD40 ligand, P- and E-selectin, NT-proBNP, fibrinogen and cystatin C at hospital admission. Two outcomes at 1-year follow up were selected for analysis: (1) all-cause death, MI, UA, or coronary revascularization, and (2) all-cause death, and non-fatal MI. The effect of biomarker levels on endpoints was examined by the Cox proportional hazards model, and their discrimination ability with the C statistic (AUC).
Results: Of 549 patients (90.0%) who completed the 1-year follow up, 206 (37.5%) and 54 (8.9%) reached the first and second composite endpoints, respectively. None of the biomarkers studied improved prediction of the first endpoint. However, considered as continuous variables, and in combination, NT-proBNP and fibrinogen, increased the AUC from 0.64 (95% CI 0.55-0.72) to 0.73 (95% CI 0.64-0.81; p=0.02) for prediction of the second endpoint. Cut-off values for NT-proBNP and fibrinogen, regarding best sensitivity and specificity for prediction of the secondary endpoint were 1043.9 ng/L and 4.47 mg/dL, respectively. For these cut-off points, sensitivity, specificity, positive predictive value and negative predictive value were 40.5% vs 59.5%, 83.3% vs 67.1%, 18.8% vs 14.9% and 93.5% vs 94.4% for NT-proBNP and fibrinogen, respectively.
Conclusion: In ACS patients, inflammatory biomarkers offer modest incremental information to that provided by clinical risk markers. Fibrinogen and NT-proBNP measurements, however, improve cardiovascular risk prediction.
(Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)
المشرفين على المادة: 0 (Biomarkers)
114471-18-0 (Natriuretic Peptide, Brain)
تواريخ الأحداث: Date Created: 20100713 Date Completed: 20110302 Latest Revision: 20151119
رمز التحديث: 20221213
DOI: 10.1016/j.atherosclerosis.2010.06.026
PMID: 20619836
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-1484
DOI:10.1016/j.atherosclerosis.2010.06.026