Aggregate risk score based on markers of inflammation, cell stress, and coagulation is an independent predictor of adverse cardiovascular outcomes.

MedStar author(s):
Citation: Journal of the American College of Cardiology. 62(4):329-37, 2013 Jul 23.PMID: 23665099Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *C-Reactive Protein/me [Metabolism] | *Cardiovascular Diseases/me [Metabolism] | *Cardiovascular Diseases/pa [Pathology] | *Coronary Artery Disease/me [Metabolism] | *Coronary Artery Disease/pa [Pathology] | *Fibrin Fibrinogen Degradation Products/me [Metabolism] | *HSP70 Heat-Shock Proteins/me [Metabolism] | *Severity of Illness Index | Aged | Biological Markers/bl [Blood] | Cardiovascular Diseases/mo [Mortality] | Cohort Studies | Coronary Artery Disease/mo [Mortality] | Female | Follow-Up Studies | Humans | Inflammation/me [Metabolism] | Inflammation/mo [Mortality] | Inflammation/pa [Pathology] | Male | Middle Aged | Predictive Value of Tests | Risk FactorsLocal holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:
  • 0735-1097
Name of journal: Journal of the American College of CardiologyAbstract: BACKGROUND: Activation of inflammatory, coagulation, and cellular stress pathways contribute to atherosclerotic plaque rupture.We hypothesized that an aggregate risk score comprised of biomarkers involved in these different pathways-high-sensitivity C-reactive protein (CRP), fibrin degradation products (FDP), and heat shock protein 70(HSP70) levels-would be a powerful predictor of death and MI.CONCLUSIONS: An aggregate score based on serum levels of CRP, FDP, and HSP70 is a predictor of future risk of death and MI inpatients with suspected or known CAD. Copyright 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.METHODS: Serum levels of CRP, FDP, and HSP70 were measured in 3,415 consecutive patients with suspected or confirmed coronary artery disease (CAD) undergoing cardiac catheterization. Survival analyses were performed with models adjusted for established risk factors.OBJECTIVES: This study sought to determine an aggregate, pathway-specific risk score for enhanced prediction of deathand myocardial infarction (MI).RESULTS: Median follow-up was 2.3 years. Hazard ratios (HRs) for all-cause death and MI based on cutpoints were as follows: CRP>=3.0 mg/l, HR: 1.61; HSP70 >0.625 ng/ml, HR; 2.26; and FDP>=1.0 mug/ml, HR: 1.62 (p< 0.0001 for all). Anaggregate biomarker score between 0 and 3 was calculated based on these cutpoints. Compared with the groupwith a 0 score, HRs for all-cause death and MI were 1.83, 3.46, and 4.99 for those with scores of 1, 2, and 3, respectively (p for each:<0.001). Annual event rates were 16.3% for the 4.2% of patients with a score of 3 compared with 2.4% in 36.4% of patients with a score of 0. The C statistic and net reclassification improved (p<0.0001) with the addition of the biomarker score.All authors: Eapen DJ, Epstein SE, Hammadah M, Malayter D, Manocha P, Nanjundappa RA, Patel RS, Quyyumi AA, Sikora S, Sperling L, Veledar E, Wassel C, Wilson PWDigital Object Identifier: Date added to catalog: 2013-12-24
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 23665099

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

BACKGROUND: Activation of inflammatory, coagulation, and cellular stress pathways contribute to atherosclerotic plaque rupture.We hypothesized that an aggregate risk score comprised of biomarkers involved in these different pathways-high-sensitivity C-reactive protein (CRP), fibrin degradation products (FDP), and heat shock protein 70(HSP70) levels-would be a powerful predictor of death and MI.

CONCLUSIONS: An aggregate score based on serum levels of CRP, FDP, and HSP70 is a predictor of future risk of death and MI inpatients with suspected or known CAD. Copyright 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

METHODS: Serum levels of CRP, FDP, and HSP70 were measured in 3,415 consecutive patients with suspected or confirmed coronary artery disease (CAD) undergoing cardiac catheterization. Survival analyses were performed with models adjusted for established risk factors.

OBJECTIVES: This study sought to determine an aggregate, pathway-specific risk score for enhanced prediction of deathand myocardial infarction (MI).

RESULTS: Median follow-up was 2.3 years. Hazard ratios (HRs) for all-cause death and MI based on cutpoints were as follows: CRP>=3.0 mg/l, HR: 1.61; HSP70 >0.625 ng/ml, HR; 2.26; and FDP>=1.0 mug/ml, HR: 1.62 (p< 0.0001 for all). Anaggregate biomarker score between 0 and 3 was calculated based on these cutpoints. Compared with the groupwith a 0 score, HRs for all-cause death and MI were 1.83, 3.46, and 4.99 for those with scores of 1, 2, and 3, respectively (p for each:<0.001). Annual event rates were 16.3% for the 4.2% of patients with a score of 3 compared with 2.4% in 36.4% of patients with a score of 0. The C statistic and net reclassification improved (p<0.0001) with the addition of the biomarker score.

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