Biomarkers in stable coronary heart disease, their modulation and cardiovascular risk: The LIPID biomarker study

International Journal of Cardiology
Andrew TonkinLIPID Study Investigators

Abstract

In patients with stable coronary heart disease (CHD), we aimed to assess 1. the prognostic power of biomarkers reflecting haemodynamics, micronecrosis, inflammation, coagulation, lipids, neurohumoral activity, and renal function; 2. whether changes in concentrations of these biomarkers over 12 months affected subsequent CHD risk; and 3. whether pravastatin modified the change in biomarker concentrations and this influenced the risk of future events. In the LIPID study, 9014 patients were randomised to pravastatin 40 mg or placebo 3-36 months after an acute coronary syndrome. Eight biomarkers were measured at baseline (n=7863) and 12 months later (n=6434). During a median of 6.0 (IQR 5.5-6.5) years follow-up, 1100 CHD-related deaths and nonfatal myocardial infarctions occurred, 694 after biomarker measurement at 12 months. Baseline BNP, CRP, cystatin C, D-dimer, midregional pro-adrenomedullin, and sensitive troponin I predicted recurrent CHD events. In a multivariable model, sensitive troponin I, BNP, and cystatin C had the strongest associations with outcome (P<0.001 for trend). The strongest improvement in risk prediction was achieved by including sensitive troponin I (net reclassification improvement (NRI) 5.5%; P=0.003), BNP...Continue Reading

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Citations

Jun 28, 2017·Heart·Ralph A H StewartUNKNOWN LIPID Study Investigators
Oct 16, 2019·The Cochrane Database of Systematic Reviews·Claire SweeneyJoe Gallagher
Feb 22, 2017·Current Cardiology Reports·Anum Saeed, Christie M Ballantyne
May 22, 2019·European Journal of Clinical Investigation·Suzanne Schol-GelokTeun van Gelder
Nov 24, 2020·Clinical Chemistry·Paul M HallerJohannes T Neumann
Jan 6, 2021·American Heart Journal·Maria TomasdottirZiad Hijazi

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