Abstract
In order to prioritize limited health resources in a time of increasing demands optimal cardiovascular risk stratification is essential. We tested the additive prognostic value of 3 relatively new, but established cardiovascular risk markers: N-terminal pro brain natriuretic peptide (Nt-proBNP), related to hemodynamic cardiovascular risk factors, high sensitivity C-reactive protein (hsCRP), related to metabolic cardiovascular risk factors and urine albumin/creatinine ratio (UACR), related to hemodynamic as well as metabolic risk factors. In healthy subjects with a 10-year risk of cardiovascular death lower than 5% based on HeartScore and therefore not eligible for primary prevention, the actual 10-year risk of cardiovascular death exceeded 5% in a small subgroup of subjects with UACR higher than the 95-percentile of approximately 1.6 mg/mmol. Combined use of high UACR or high hsCRP identified a larger subgroup of 16% with high cardiovascular risk in which primary prevention may be advised despite low-moderate cardiovascular risk based on HeartScore. Furthermore, combined use of high UACR or high Nt-proBNP in subjects with known cardiovascular disease or diabetes identified a large subgroup of 48% with extremely high cardiovascular risk who should be referred for specialist care to optimize treatment.
Keywords: Urine albumin/creatinine ratio, high sensitivity C-reactive protein, N-terminal pro brain natriuretic peptide, risk stratification, prognosis, general population
Current Vascular Pharmacology
Title: Urine Albumin/Creatinine Ratio, High Sensitivity C-Reactive Protein and N-Terminal Pro Brain Natriuretic Peptide - Three New Cardiovascular Risk Markers - Do They Improve Risk Prediction and Influence Treatment?
Volume: 8 Issue: 1
Author(s): Michael H. Olsen, Thomas Sehestedt, Stig Lyngbaek, Tine W. Hansen, Susanne Rasmussen, Kristian Wachtell, Christian Torp-Pedersen, Per R. Hildebrandt and Hans Ibsen
Affiliation:
Keywords: Urine albumin/creatinine ratio, high sensitivity C-reactive protein, N-terminal pro brain natriuretic peptide, risk stratification, prognosis, general population
Abstract: In order to prioritize limited health resources in a time of increasing demands optimal cardiovascular risk stratification is essential. We tested the additive prognostic value of 3 relatively new, but established cardiovascular risk markers: N-terminal pro brain natriuretic peptide (Nt-proBNP), related to hemodynamic cardiovascular risk factors, high sensitivity C-reactive protein (hsCRP), related to metabolic cardiovascular risk factors and urine albumin/creatinine ratio (UACR), related to hemodynamic as well as metabolic risk factors. In healthy subjects with a 10-year risk of cardiovascular death lower than 5% based on HeartScore and therefore not eligible for primary prevention, the actual 10-year risk of cardiovascular death exceeded 5% in a small subgroup of subjects with UACR higher than the 95-percentile of approximately 1.6 mg/mmol. Combined use of high UACR or high hsCRP identified a larger subgroup of 16% with high cardiovascular risk in which primary prevention may be advised despite low-moderate cardiovascular risk based on HeartScore. Furthermore, combined use of high UACR or high Nt-proBNP in subjects with known cardiovascular disease or diabetes identified a large subgroup of 48% with extremely high cardiovascular risk who should be referred for specialist care to optimize treatment.
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Olsen H. Michael, Sehestedt Thomas, Lyngbaek Stig, Hansen W. Tine, Rasmussen Susanne, Wachtell Kristian, Torp-Pedersen Christian, Hildebrandt R. Per and Ibsen Hans, Urine Albumin/Creatinine Ratio, High Sensitivity C-Reactive Protein and N-Terminal Pro Brain Natriuretic Peptide - Three New Cardiovascular Risk Markers - Do They Improve Risk Prediction and Influence Treatment?, Current Vascular Pharmacology 2010; 8 (1) . https://dx.doi.org/10.2174/157016110790226633
DOI https://dx.doi.org/10.2174/157016110790226633 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
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Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
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