Abstract
Background
In the Gutenberg Health Study, a random sample of the population was scanned with vascular ultrasound for early atherosclerosis. A continuous classical risk marker model (waist circumference, HbA1c, LDL/HDL ratio, pack years and pulse pressure) was compared to a model of modern biomarkers (C-reactive protein, troponin I, N-terminal pro B-type natriuretic peptide, copeptin, mid-regional pro-adrenomedullin, and asymmetric dimethylarginine) with regard to the ability of ruling out abnormal intima-media thickness (IMT), respectively, carotid plaques.
Methods
Data of the first consecutive 5,000 participants (aged 35–74 years; 2,540 men, 2,460 women) were analyzed. IMT was measured at both common carotid arteries using an edge detection system. Plaques were defined as protrusion of ≥1.5 mm in common, internal and external carotid artery.
Results
For classical risk factors, in comparison to a model of six modern biomarkers, regarding the variable (a) IMT>0.85 mm negative and positive predictive value (NPV and PPV) were 0.98 and 0.16 for both the classical risk factor model and the biomarker model. The second variable (b) presence of plaque could be ruled out with an NPV of 0.84 and identified with a PPV of 0.61 for classical risk factors, and 0.84 and 0.58 for biomarkers, respectively. Values were calculated using logistic regression analysis.
Conclusion
Classical risk factors allow ruling out pathologic IMT and presence of carotid plaques in a population of primary prevention in a reliable way. Modern biomarkers performed almost equally well but did not provide further information.
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Abbreviations
- ADMA:
-
Asymmetric dimethylarginine
- CCA:
-
Common carotid artery
- CRP:
-
C-reactive protein
- CVD:
-
Cardiovascular disease
- GHS:
-
Gutenberg Health Study
- IMT:
-
Intima-media thickness
- MR-proADM:
-
Mid-regional pro-adrenomedullin
- NPV:
-
Negative predictive value
- NT-proBNP:
-
N-terminal pro B-type natriuretic peptide
- PPV:
-
Positive predictive value
- TnI:
-
Troponin I
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Acknowledgements:
The Gutenberg Health Study is funded through the government of Rheinland-Pfalz (“Stiftung Rheinland Pfalz für Innovation,” Contract No. AZ 961–386261/733), the research programs “Wissen schafft Zukunft” and “Schwerpunkt Vaskuläre Prävention” of the Johannes Gutenberg-University of Mainz, and its contract with Boehringer Ingelheim and Philips Medical Systems including unrestricted support for the GHS as well as support from Abbott Diagnostics. The testkits for Copeptin and MR-proADM were provided by B.R.A.H.M.S Hennigsdorf and for Nt-proBNP by Roche Diagnostics Mannheim at no cost ADMA measurements were paid for by the “Stiftung für Biochemie” of the University Hamburg-Eppendorf, Department for Experimental Pharmacology and Toxicology.
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For the Gutenberg Health Study.
C. Sinning and A. Kieback contributed equally to this work.
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Sinning, C., Kieback, A., Wild, P.S. et al. Association of multiple biomarkers and classical risk factors with early carotid atherosclerosis: results from the Gutenberg Health Study. Clin Res Cardiol 103, 477–485 (2014). https://doi.org/10.1007/s00392-014-0674-6
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DOI: https://doi.org/10.1007/s00392-014-0674-6