Occurrence of coronary events in the absence of traditional risk factors: Understanding residual risk.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Arnold Natalie, Goßling Alina, Weimann Jessica, Bay Benjamin, Zeller Tanja, Ferrario Marco M, Palmieri Luigi, Amouyel Philippe, Moitry Marie, Ferrières Jean, Brenner Hermann, Tamosiunas Abdonas, Malyutina Sofia, Männistö Satu, Drygas Wojciech, Grassi Guido, Grimsgaard Sameline, Linneberg Allan, Söderberg Stefan, Iacoviello Licia, Sans Susana, Schnabel Renate, Veronesi Giovanni, Thorand Barbara, Tunstall-Pedoe Hugh, Kee Frank, Salomaa Veikko, Kuulasmaa Kari, Blankenberg Stefan, Waldeyer Christoph, Ojeda Francisco, Magnussen Christina, Koenig Wolfgang, MORGAM investigators
Аннотация
METHODS: Overall 212,598 CHD-free individuals from 21 European population-based cohorts were stratified by CVRF burden into three groups, having zero (n = 35,707), one (n = 68,548) or ≥2 (n = 108,343) risk factors at baseline. Five biomarkers (triglycerides (TGs), high-sensitivity C-reactive protein (hsCRP), cystatin C, N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I) were assessed in a subset with available measurements.
RESULTS: During a median follow-up of 13.97 years, 17,499 participants developed incident CHD with 453 events occurring among individuals without CVRFs. Although increased concentrations of all biomarkers were related to incident CHD, significant risk modulation by CVRFs was seen only for TGs and, to a lesser extent, for hsCRP. The fully-adjusted sub-distribution Hazard Ratios (95 % CI) were for TGs (≥vs < 1.70 mmol/L) 1.66 (1.29-2.15) in those without CVRFs versus 1.35 (1.21-1.49)/1.14 (1.07-1.20) in those with 1 or ≥2 risk factors (pinteraction<0.01) and for hsCRP (≥vs < 2 mg/L) 1.39 (1.02-1.90) versus 1.42 (1.26-1.61) or 1.22 (1.13-1.32), respectively (pinteraction = 0.092).
CONCLUSION: Even in the absence of CVRFs, elevated triglycerides and hsCRP were significantly associated with an increased risk of CHD. These results highlight the importance of residual risk assessment using those biomarkers in individuals deemed metabolically healthy by conventional standards.