Serial measurement of N-terminal pro-B-type natriuretic peptide and cardiac troponin T for cardiovascular disease risk assessment in the Multi-Ethnic Study of Atherosclerosis (MESA).
Serial measurement of N-terminal pro-B-type natriuretic peptide and cardiac troponin T for cardiovascular disease risk assessment in the Multi-Ethnic Study of Atherosclerosis (MESA).
复制标题
在动脉粥样硬化的多种族研究中，N末端pro-B型纳特里肽和心脏肌钙蛋白T的序列测量用于心血管疾病风险评估（MESA）。
DOI：
10.1016/j.ahj.2015.09.010
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发表时间：
2015-12
影响因子：
4.8
通讯作者：
Criqui MH
中科院分区：
文献类型：
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作者：
Daniels LB;Clopton P;deFilippi CR;Sanchez OA;Bahrami H;Lima JA;Tracy RP;Siscovick D;Bertoni AG;Greenland P;Cushman M;Maisel AS;Criqui MH
n -末端前b型利钠肽（NT-proBNP）和心脏肌钙蛋白T （TnT）在各种人群中预测心血管疾病（CVD）的风险。他们的预测价值是否因种族而异尚不清楚。我们试图确定：NT-proBNP和TnT是否在独立于CVD危险因素的情况下，在多民族人群中改善冠心病和CVD事件的预测；与弗雷明汉风险评分（FRS）或合并队列风险方程（PCRE）相比，NT-proBNP是否提高了预测；以及第二次NT-proBNP是否能进一步提高预测能力。在2000-2002年和2004-2005年5592名动脉粥样硬化多种族研究参与者（60%非白人，平均年龄62.3±10.3岁）中测量NT-proBNP和TnT。我们根据基线和生物标志物浓度的变化评估冠心病和心血管疾病发生的调整风险。随访至2011年，参与者发生了370例心血管疾病（232例冠心病）。NT-proBNP和TnT浓度因种族而异。NT-proBNP和TnT与事件风险增加相关（第5 / 4 NT-proBNP的冠心病校正HR [95% CI]为2.03[1.50-2.76]；可检测到TnT与不可检测到TnT的冠心病HR为3.95[2.29-6.81]）。与FRS和PCRE相比，NT-proBNP改善了风险预测和分类。NT-proBNP的变化与事件独立相关（冠心病每单位增加的HR为ΔlogNT-proBNP， 1.95[1.16-3.26]）。所有观察到的关联都没有因种族而异。NT-proBNP和TnT是无已知心血管疾病的多民族人群中发生冠心病的独立危险因素和种族的预测因子。NT-proBNP的变化可能会增加额外的预后信息。
N-terminal-pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (TnT) predict cardiovascular disease (CVD) risk in a variety of populations. Whether their predictive value varies by ethnicity is unknown. We sought to determine: whether NT-proBNP and TnT improve prediction of incident coronary heart disease (CHD) and CVD, independent of CVD risk factors, in a multi-ethnic population; whether NT-proBNP improves prediction compared to the Framingham Risk Score (FRS) or the Pooled Cohort Risk Equation (PCRE); and whether a second NT-proBNP further improves prediction. NT-proBNP and TnT were measured in 5592 Multi-Ethnic Study of Atherosclerosis white, black, Hispanic and Chinese participants (60% nonwhite, mean age 62.3±10.3) in 2000–2002 and 2004–2005. We evaluated adjusted risk of incident CHD and CVD based on baseline and change in biomarker concentration. Participants were followed through 2011 and incurred 370 CVD events (232 CHD). NT-proBNP and TnT concentrations varied by ethnicity. NT-proBNP and TnT were associated with an increased risk of events (adjusted HR for CHD [95% CI] for 5th versus other 4 quintiles of NT-proBNP, 2.03[1.50–2.76]; HR for CHD for detectable versus undetectable TnT, 3.95[2.29–6.81]). NT-proBNP improved risk prediction and classification compared to the FRS and the PCRE. Change in NT-proBNP was independently associated with events (HR for CHD per unit increase in ΔlogNT-proBNP, 1.95[1.16–3.26]). None of the observed associations varied by ethnicity. NT-proBNP and TnT are predictors of incident CHD, independent of established risk factors and ethnicity, in a multi-ethnic population without known CVD. Change in NT-proBNP may add additional prognostic information.