Which biomarkers are predictive specifically for cardiovascular or for non-cardiovascular mortality in men? Evidence from the Caerphilly Prospective Study (CaPS). (15th December 2015)

• Record Type: Journal Article
• Authors: Patterson, Christopher C.; Blankenberg, Stefan; Ben-Shlomo, Yoav; Heslop, Luke; Bayer, Antony; Lowe, Gordon; Zeller, Tanja; Gallacher, John; Young, Ian; Yarnell, John
• Is Part Of: International journal of cardiology. Volume 201(2015)
• Page Start: 113
• Page End: 118
• Publication Date: 2015-12-15
• Subjects: Biomarkers -- Cardiovascular mortality -- Non-cardiovascular mortality -- Epidemiology; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2015.07.106
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Objective: To examine a panel of 28 biomarkers for prediction of cardiovascular disease (CVD) and non-CVD mortality in a population-based cohort of men. Methods: Starting in 1979, middle-aged men in Caerphilly underwent detailed medical examination. Subsequently 2171 men were re-examined during 1989–1993, and fasting blood samples obtained from 1911 men (88%). Fibrinogen, viscosity and white cell count (WCC), routine biochemistry tests and lipids were analysed using fresh samples. Stored aliquots were later analysed for novel biomarkers. Statistical analysis of CVD and non-CVD mortality follow-up used competing risk Cox regression models with biomarkers in thirds tested at the 1% significance level after covariate adjustment. Results: During an average of 15.4 years follow-up, troponin (subhazard ratio per third 1.71, 95% CI 1.46–1.99) and B-natriuretic peptide (BNP) (subhazard ratio per third 1.54, 95% CI 1.34–1.78) showed strong trends with CVD death but not with non-CVD death. WCC and fibrinogen showed similar weaker findings. Plasma viscosity, growth differentiation factor 15 (GDF-15) and interleukin-6 (IL-6) were associated positively with both CVD death and non-CVD death while total cholesterol was associated positively with CVD death but negatively with non-CVD death. C-reactive protein (C-RP), alkaline phosphatase, gamma-glutamyltransferase (GGT), retinol binding protein 4 (RBP-4) and vitamin B6 were significantly associated only with non-CVD death, the last two negatively. Troponin, BNP and IL-6 showed evidence of diminishing associations with CVD mortality through follow-up. Conclusion: Biomarkers for cardiac necrosis were strong, specific predictors of CVD mortality while many inflammatory markers were equally predictive of non-CVD mortality.