دورية أكاديمية

C-Reactive Protein, Fibrinogen, and Cardiovascular Disease Prediction

التفاصيل البيبلوغرافية
العنوان: C-Reactive Protein, Fibrinogen, and Cardiovascular Disease Prediction
المؤلفون: Kaptoge, Stephen, Di Angelantonio, Emanuele, Pennells, Lisa, Wood, Angela M., White, Ian R., Gao, Pei, Walker, Matthew, Thompson, Alexander, Sarwar, Nadeem, Caslake, Muriel, Butterworth, Adam S., Amouyel, Philippe, Assmann, Gerd, Bakker, Stephan J. L., Barr, Elizabeth L. M., Barrett-Connor, Elizabeth, Benjamin, Emelia J., Bjorkelund, Cecilia, Brenner, Hermann, Brunner, Eric, Clarke, Robert, Cooper, Jackie A., Cremer, Peter, Cushman, Mary, Dagenais, Gilles R., D'Agostino, Ralph B., Dankner, Rachel, Davey-Smith, George, Deeg, Dorly, Dekker, Jacqueline M., Engstrom, Gunnar, Folsom, Aaron R., Fowkes, F. Gerry R., Gallacher, John, Gaziano, J. Michael, Giampaoli, Simona, Gillum, Richard F., Hofman, Albert, Howard, Barbara V., Ingelsson, Erik, Iso, Hiroyasu, Jorgensen, Torben, Kiechl, Stefan, Kitamura, Akihiko, Kiyohara, Yutaka, Koenig, Wolfgang, Kromhout, Daan, Kuller, Lewis H., Lawlor, Debbie A., Meade, Tom W.
المصدر: Kaptoge , S , Di Angelantonio , E , Pennells , L , Wood , A M , White , I R , Gao , P , Walker , M , Thompson , A , Sarwar , N , Caslake , M , Butterworth , A S , Amouyel , P , Assmann , G , Bakker , S J L , Barr , E L M , Barrett-Connor , E , Benjamin , E J , Bjorkelund , C , Brenner , H , Brunner , E , Clarke , R , Cooper , J A , Cremer ....
سنة النشر: 2012
المجموعة: University of Groningen research database
مصطلحات موضوعية: CORONARY-HEART-DISEASE, NONVASCULAR MORTALITY, PRACTICE GUIDELINES, PRIMARY PREVENTION, COST-EFFECTIVENESS, STATIN THERAPY, RISK PROFILE, ASSOCIATION, INFLAMMATION, METAANALYSIS
الوصف: Background There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events. Methods We analyzed data from 52 prospective studies that included 246,669 participants without a history of cardiovascular disease to investigate the value of adding CRP or fibrinogen levels to conventional risk factors for the prediction of cardiovascular risk. We calculated measures of discrimination and reclassification during follow-up and modeled the clinical implications of initiation of statin therapy after the assessment of CRP or fibrinogen. Results The addition of information on high-density lipoprotein cholesterol to a prognostic model for cardiovascular disease that included age, sex, smoking status, blood pressure, history of diabetes, and total cholesterol level increased the C-index, a measure of risk discrimination, by 0.0050. The further addition to this model of information on CRP or fibrinogen increased the C-index by 0.0039 and 0.0027, respectively (P <0.001), and yielded a net reclassification improvement of 1.52% and 0.83%, respectively, for the predicted 10-year risk categories of "low" (<10%), " intermediate" (10% to <20%), and "high" (>= 20%) (P <0.02 for both comparisons). We estimated that among 100,000 adults 40 years of age or older, 15,025 persons would initially be classified as being at intermediate risk for a cardiovascular event if conventional risk factors alone were used to calculate risk. Assuming that statin therapy would be initiated in accordance with Adult Treatment Panel III guidelines (i.e., for persons with a predicted risk of >= 20% and for those with certain other risk factors, such as diabetes, irrespective of their 10-year predicted risk), additional targeted assessment of CRP or fibrinogen levels in the 13,199 remaining participants at intermediate risk could help prevent approximately 30 additional cardiovascular events over the course of 10 years. Conclusions In a ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
العلاقة: https://research.rug.nl/en/publications/ba049b3a-3254-4ede-bcb2-4ec887d45e1aTest
DOI: 10.1056/NEJMoa1107477
الإتاحة: https://doi.org/10.1056/NEJMoa1107477Test
https://hdl.handle.net/11370/ba049b3a-3254-4ede-bcb2-4ec887d45e1aTest
https://research.rug.nl/en/publications/ba049b3a-3254-4ede-bcb2-4ec887d45e1aTest
حقوق: info:eu-repo/semantics/restrictedAccess
رقم الانضمام: edsbas.F096969E
قاعدة البيانات: BASE