Long-term prognostic value of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) changes within one year in patients with coronary heart disease

Size: px
Start display at page:

Download "Long-term prognostic value of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) changes within one year in patients with coronary heart disease"

Transcription

1 Long-term prognostic value of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) changes within one year in patients with coronary heart disease D. Dallmeier 1, D. Rothenbacher 2, W. Koenig 1, H. Brenner 3 Dhayana Dallmeier, MD 1 Dept. of Internal Medicine II - Cardiology, University of Ulm Medical Center, Germany 2 Institute of Epidemiology and Medical Biometry, 3 German Cancer Research Center, Division of Clinical Epidemiology & Aging Research 1

2 I have nothing to disclose. 2

3 Every year worldwide 7 million people experience a myocardial infarction (MI) Among survivors about 20% will suffer a recurrent cardiovascular event during the first 5 years after the initial event N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE 3 3

4 N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE Single measurements have shown strong prognostic value for cardiovascular events, all-cause mortality or heart failure NT-proBNP guided therapy has been associated with a reduced number of cardiovascular events among patients with heart failure Longitudinal NT-proBNP measurements are recommended for further risk assessment among patients with heart failure Longitudinal changes have been evaluated for time periods < 1 year Less is known about the prognostic value of longitudinal measurements among patients with stable coronary heart disease (CHD) 4 4

5 Objective To evaluate the prognostic value of a NT-proBNP 12-months change on subsequent cardiovascular disease events in patients with stable CHD Relative Change Absolute Change Cutoff of ±30% change from baseline level* Quartiles Across a set of threshold values from 100 to 1000 pg/ml NT-proBNP *Thygesen K et al. Recommendations for the use of natriuretic peptides in acute cardiac care: A position statement from the Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. Eur Heart J

6 Baseline Study Population 1206 patients with CHD participating in a cardiac rehabilitation program between January 1999 April year 3 years 4.5 years 6 years 8 years 10 years All secondary cardiovascular events NT-proBNP 6 6

7 1206 Participants Time to follow-up < 365 days (n=145) Missing values for NT-proBNP at baseline (n=16) at one year follow-up (n=106) at baseline and one year follow-up (n=8) Missing left ventricular function at baseline (n=98) Missing creatinine at baseline (n=98) 826 Participants (121 events) 7 7

8 Statistical Analysis Cox proportional hazard model Outcome All secondary cardiovascular events Covariates at baseline Age Sex Body Mass Index Creatinine Total cholesterol HDL cholesterol Medication Type of treatment Left ventricular function History of MI History of diabetes History of hypertension Smoking status 8 8

9 Results Table 1. Baseline participants characteristics (n=826) Age (mean, SD) 59 ± 8 Male (n (%)) 696 (84.3) Body Mass Index (kg/m 2 ) (mean, SD) 27.0 ± 3.5 Smoking Never Smoker (n (%)) 273 (33.1) Ex-smoker (n (%)) 519 (62.8) Current smoker (n (%)) 34 (4.1) History of Hypertension n (%) 457 (55.3) History of Myocardial Infarction n (%) 426 (51.6) Coronary Artery Bypass Graft n (%) 403 (48.8) History of Diabetes n (%) 132 (15.9) Left Ventricular Function Normal (n (%)) 451 (54.6) Mild depression (n (%)) 200 (24.2) Moderate depression (n (%)) 127 (15.4) Severe depression (n (%)) 48 (5.8) Serum Creatinine (mg/dl) (mean, SD) 0.93 ± 0.3 Total Cholesterol (mg/dl) (mean, SD) 168 ± 32 HDL Cholesterol (mg/dl) (mean, SD) 40 ±

10 Table 2. NT-proBNP median levels (pg/ml) stratified by sex n Male 696 Female 130 Baseline (Q1, Q3) (274, 1030) (345.9, 1634) 1 year follow-up (Q1, Q3) 177 (86.5, 371) 266 (113, 491) 10 10

11 Relative Change Table 3. Multivariable analysis for NT-proBNP relative change No. of events/ No. of subjects HR (95% CI) P value < -30% 99/ ( ) Cutoff of 30% change from baseline level [-30%, 30%] 19/89 Reference > 30% 3/ ( ) 0.25 Quartiles of relative change [IQR] Q1 [-96.93; ] Q2 [ ; ] Q3 [-66.4; ] 18/ ( ) < / ( ) / ( ) Q4 [-47.2; 438.4] 39/206 Reference Adjusted for baseline NT-proBNP (log), age, sex, left ventricular function and history of diabetes 11 11

12 NT-proBNP (pg/ml) Absolute Change High High High Low Low High Low Low Table 4. Model performances across NT-proBNP threshold levels from 600 to 1000 pg/ml Threshold Level (pg/ml) AIC SBC P value Global Model Adjusting for baseline NT-proBNP (log), age, sex, left ventricular function and history of diabetes. AIC Akaike s Information Criterion, SBC Schwarz-Bayes Criterion 12 12

13 Strengths Long-term follow-up with a high completeness rate Limitations Mostly male, white patients Insufficient case number to allow separate analyses (sex, ethnicity) Composite outcome fatal and non-fatal cardiovascular events Generalizability may be affected by low cardiac rehab participation rates 13 13

14 Conclusions The observed high baseline levels of NT-proBNP tended to normalize at one year follow-up A relative change <-30% at one year follow-up was associated with a strong reduction of the risk for a secondary cardiovascular event A threshold value of 700 pg/ml seemed the most suitable one for the prognostic assessment in stable CHD patients 14 14

15 Among those who survived the first year after an acute event, 12-month follow-up measurements of NT-proBNP can provide additional prognostic information with respect to the onset of secondary cardiovascular events 15

16 16

17 Baseline Study Population 1206 patients with CHD participating in a cardiac rehabilitation program between January 1999 April year 3 years 4.5 years 6 years 8 years 10 years All secondary cardiovascular events NT-proBNP Mean time from primary event to blood withdrawal 46.3 days (SD 13.6) 17

18 Supplementary Table 1. Absolute changes between baseline and one year follow-up across different threshold levels Categories of Absolute Change Events/Subjects HR 95% CI P value P value Global Model From < 1000 to < /591 Reference From 1000 to < / [ ] 0.74 From < 1000 to / [ ] 0.25 From 1000 to / [ ] 0.04 From < 900 to < /560 Reference From 900 to < / [ ] 0.23 From < 900 to 900 2/ [ ] 0.16 From 900 to / [ ] 0.01 From < 800 to < /526 Reference From 800 to < / [ ] 0.26 From < 800 to 800 1/ [ ] 0.49 From 800 to / [ ] From < 700 to < /489 Reference From 700 to < / [ ] 0.13 From < 700 to 700 2/ [ ] 0.09 From 700 to / [ ] From < 600 to < /428 Reference From 600 to < / [ ] From < 600 to 600 1/ [ ] 0.66 From 600 to / [ ] Adjusted for baseline NT-proBNP (log), age, sex, left ventricular function and history of diabetes 18

High-sensitivity Troponin T Predicts Recurrent Cardiovascular Events in Patients with Stable Coronary Heart Disease: KAROLA Study 8 Year FU

High-sensitivity Troponin T Predicts Recurrent Cardiovascular Events in Patients with Stable Coronary Heart Disease: KAROLA Study 8 Year FU ESC Congress 2011 Paris, France, August 27-31 KAROLA Session: Prevention: Are biomarkers worth their money? Abstract # 84698 High-sensitivity Troponin T Predicts Recurrent Cardiovascular Events in Patients

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content McEvoy JW, Chen Y, Ndumele CE, et al. Six-year change in high-sensitivity cardiac troponin T and risk of subsequent coronary heart disease, heart failure, and death. JAMA Cardiol.

More information

Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes

Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Seung-Jae Joo and other KAMIR-NIH investigators Department of Cardiology, Jeju National

More information

The Framingham Risk Score (FRS) is widely recommended

The Framingham Risk Score (FRS) is widely recommended C-Reactive Protein Modulates Risk Prediction Based on the Framingham Score Implications for Future Risk Assessment: Results From a Large Cohort Study in Southern Germany Wolfgang Koenig, MD; Hannelore

More information

Supplement materials:

Supplement materials: Supplement materials: Table S1: ICD-9 codes used to define prevalent comorbid conditions and incident conditions Comorbid condition ICD-9 code Hypertension 401-405 Diabetes mellitus 250.x Myocardial infarction

More information

Performance and Quality Measures 1. NQF Measure Number. Coronary Artery Disease Measure Set

Performance and Quality Measures 1. NQF Measure Number. Coronary Artery Disease Measure Set Unless indicated, the PINNACLE Registry measures are endorsed by the American College of Cardiology Foundation and the American Heart Association and may be used for purposes of health care insurance payer

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Leibowitz M, Karpati T, Cohen-Stavi CJ, et al. Association between achieved low-density lipoprotein levels and major adverse cardiac events in patients with stable ischemic

More information

Supplemental Table S2: Subgroup analysis for IL-6 with BMI in 3 groups

Supplemental Table S2: Subgroup analysis for IL-6 with BMI in 3 groups Supplemental Table S1: Unadjusted and Adjusted Hazard Ratios for Diabetes Associated with Baseline Factors Considered in Model 3 SMART Participants Only Unadjusted Adjusted* Baseline p-value p-value Covariate

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Li S, Chiuve SE, Flint A, et al. Better diet quality and decreased mortality among myocardial infarction survivors. JAMA Intern Med. Published online September 2, 2013. doi:10.1001/jamainternmed.2013.9768.

More information

BNP as a Predictor of Cardiovascular Disease and All Cause Mortality. Dr. Thierry Le Jemtel

BNP as a Predictor of Cardiovascular Disease and All Cause Mortality. Dr. Thierry Le Jemtel BNP as a Predictor of Cardiovascular Disease and All Cause Mortality Dr. Thierry Le Jemtel Outline Role of BNP and probnp as relevant biomarkers in cardiac conditions Role of BNP and probnp as relevant

More information

Race Original cohort Clean cohort HR 95%CI P HR 95%CI P. <8.5 White Black

Race Original cohort Clean cohort HR 95%CI P HR 95%CI P. <8.5 White Black Appendix Table 1: Hazard Ratios of the association between CSCs and all-cause mortality from original cohort and the clean cohort excluding CHD/strokes. CSC categories Race Original cohort Clean cohort

More information

Low ALT Levels Independently Associated with 22-Year All-Cause Mortality Among Coronary Heart Disease Patients

Low ALT Levels Independently Associated with 22-Year All-Cause Mortality Among Coronary Heart Disease Patients Low ALT Levels Independently Associated with 22-Year All-Cause Mortality Among Coronary Heart Disease Patients N. Peltz-Sinvani, MD 1,4,R.Klempfner,MD 2,4, E. Ramaty, MD 1,4,B.A.Sela,PhD 3,4,I.Goldenberg,MD

More information

ORIGINAL INVESTIGATION

ORIGINAL INVESTIGATION ORIGINAL INVESTIGATION Comparison of N-Terminal Pro B-Natriuretic Peptide, C-Reactive Protein, and Creatinine Clearance for Prognosis in Patients With Known Coronary Heart Disease Dietrich Rothenbacher,

More information

Biomarkers in the Assessment of Congestive Heart Failure

Biomarkers in the Assessment of Congestive Heart Failure Biomarkers in the Assessment of Congestive Heart Failure Mid-Regional pro-adrenomedullin (MR-proADM) vs BNP & NT-proBNP as Prognosticator in Heart Failure Patients: Results of the BACH Multinational Trial

More information

GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS

GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS Table of Contents List of authors pag 2 Supplemental figure I pag 3 Supplemental figure II pag 4 Supplemental

More information

B-type Natriuretic Peptide in VHD: a Non-imaging Helper for the Cardiologist. Dr. Julien Magne, PhD Sart Tilman Liège, BELGIUM

B-type Natriuretic Peptide in VHD: a Non-imaging Helper for the Cardiologist. Dr. Julien Magne, PhD Sart Tilman Liège, BELGIUM B-type Natriuretic Peptide in VHD: a Non-imaging Helper for the Cardiologist Dr. Julien Magne, PhD Sart Tilman Liège, BELGIUM Conflict of Interest Disclosure None BNP Molecular Forms and Processing Brain

More information

Trial to Reduce. Aranesp* Therapy. Cardiovascular Events with

Trial to Reduce. Aranesp* Therapy. Cardiovascular Events with Trial to Reduce Cardiovascular Events with Aranesp* Therapy John J.V. McMurray, Hajime Uno, Petr Jarolim, Akshay S. Desai, Dick de Zeeuw, Kai-Uwe Eckardt, Peter Ivanovich, Andrew S. Levey, Eldrin F. Lewis,

More information

JUPITER NEJM Poll. Panel Discussion: Literature that Should Have an Impact on our Practice: The JUPITER Study

JUPITER NEJM Poll. Panel Discussion: Literature that Should Have an Impact on our Practice: The JUPITER Study Panel Discussion: Literature that Should Have an Impact on our Practice: The Study Kaiser COAST 11 th Annual Conference Maui, August 2009 Robert Blumberg, MD, FACC Ralph Brindis, MD, MPH, FACC Primary

More information

Supplementary Table S1: Proportion of missing values presents in the original dataset

Supplementary Table S1: Proportion of missing values presents in the original dataset Supplementary Table S1: Proportion of missing values presents in the original dataset Variable Included (%) Missing (%) Age 89067 (100.0) 0 (0.0) Gender 89067 (100.0) 0 (0.0) Smoking status 80706 (90.6)

More information

Small dense low-density lipoprotein is a risk for coronary artery disease in an urban Japanese cohort: The Suita study

Small dense low-density lipoprotein is a risk for coronary artery disease in an urban Japanese cohort: The Suita study Small dense low-density lipoprotein is a risk for coronary artery disease in an urban Japanese cohort: The Suita study Hidenori Arai 1, Yoshihiro Kokubo 2, Makoto Watanabe 2, Tatsuya Sawamura 3, Tomonori

More information

Intercommunale de Santé Publique du Pays de Charleroi, Charleroi, Belgium 2

Intercommunale de Santé Publique du Pays de Charleroi, Charleroi, Belgium 2 Lipid Abnormalities Remain High among Treated Hypertensive Patients with Stable CHD: Results of the Dyslipidemia International Study (DYSIS) II Belgium Michel Guillaume 1, Eric Weber 2, Johan De Sutter

More information

Central pressures and prediction of cardiovascular events in erectile dysfunction patients

Central pressures and prediction of cardiovascular events in erectile dysfunction patients Central pressures and prediction of cardiovascular events in erectile dysfunction patients N. Ioakeimidis, K. Rokkas, A. Angelis, Z. Kratiras, M. Abdelrasoul, C. Georgakopoulos, D. Terentes-Printzios,

More information

pulmonary artery vasoreactivity in patients with idiopathic pulmonary arterial hypertension

pulmonary artery vasoreactivity in patients with idiopathic pulmonary arterial hypertension Supplementary material Jonas K, Magoń W, Waligóra M, et al. High density lipoprotein cholesterol levels and pulmonary artery vasoreactivity in patients with idiopathic pulmonary arterial hypertension Pol

More information

Introduction. Key words: cardiac biomarkers; short-term mortality; perioperative risk; non-cardiac surgery; coronary artery disease

Introduction. Key words: cardiac biomarkers; short-term mortality; perioperative risk; non-cardiac surgery; coronary artery disease ISSN 2466-488X (Online) doi:10.5937/sjait1806117j Original work PREOPERATIVE HIGH-SENSITIVE TROPONIN T AND N-TERMINAL PRO B-TYPE NATRIURETIC PEPTIDE IN PREDICTION OF SHORT-TERM MORTALITY AFTER NON-CARDIAC

More information

SUPPLEMENTARY DATA. Supplementary Table 1. Baseline Patient Characteristics

SUPPLEMENTARY DATA. Supplementary Table 1. Baseline Patient Characteristics Supplementary Table 1. Baseline Patient Characteristics Normally distributed data are presented as mean (±SD), data that were not of a normal distribution are presented as median (ICR). The baseline characteristics

More information

Heart Rate in Patients with Coronary Artery Disease - the Lower the Better? An Analysis from the Treating to New Targets (TNT) trial

Heart Rate in Patients with Coronary Artery Disease - the Lower the Better? An Analysis from the Treating to New Targets (TNT) trial Heart Rate in Patients with Coronary Artery Disease - the Lower the Better? An Analysis from the Treating to New Targets (TNT) trial Sripal Bangalore, MD, MHA, Chuan-Chuan Wun, PhD, David A DeMicco, PharmD,

More information

Biomarkers in risk prediction of heart and kidney disease

Biomarkers in risk prediction of heart and kidney disease Biomarkers in risk prediction of heart and kidney disease Winfried März Medizinische Universität Graz, Medizinische Klinik V Medizinische Fakultät Mannheim, Universität Heidelberg, Synlab Akademie, Mannheim

More information

SUPPLEMENTAL MATERIAL

SUPPLEMENTAL MATERIAL SUPPLEMENTAL MATERIAL Clinical perspective It was recently discovered that small RNAs, called micrornas, circulate freely and stably in human plasma. This finding has sparked interest in the potential

More information

New PINNACLE Measures The below measures for PINNACLE will be added as new measures to the outcomes reporting starting with Version 2.0.

New PINNACLE Measures The below measures for PINNACLE will be added as new measures to the outcomes reporting starting with Version 2.0. New PINNACLE Measures The below measures for PINNACLE will be added as new measures to the outcomes reporting starting with Version 2.0. Measure Steward Measure Name Measure Description Rationale for Adding

More information

Troponin Assessment. Does it Carry Clinical Message? Stefan Blankenberg. University Heart Center Hamburg

Troponin Assessment. Does it Carry Clinical Message? Stefan Blankenberg. University Heart Center Hamburg Biomarkers for Optimal Management of Heart Failure Troponin Assessment Does it Carry Clinical Message? Stefan Blankenberg University Heart Center Hamburg Congress of the European Society of Cardiology

More information

LDL cholesterol (p = 0.40). However, higher levels of HDL cholesterol (> or =1.5 mmol/l [60 mg/dl]) were associated with less progression of CAC

LDL cholesterol (p = 0.40). However, higher levels of HDL cholesterol (> or =1.5 mmol/l [60 mg/dl]) were associated with less progression of CAC Am J Cardiol (2004);94:729-32 Relation of degree of physical activity to coronary artery calcium score in asymptomatic individuals with multiple metabolic risk factors M. Y. Desai, et al. Ciccarone Preventive

More information

John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam

John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam Latest Insights from the JUPITER Study John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam Inflammation, hscrp, and Vascular Prevention

More information

egfr > 50 (n = 13,916)

egfr > 50 (n = 13,916) Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according

More information

Rikshospitalet, University of Oslo

Rikshospitalet, University of Oslo Rikshospitalet, University of Oslo Preventing heart failure by preventing coronary artery disease progression European Society of Cardiology Dyslipidemia 29.08.2010 Objectives The trends in cardiovascular

More information

Transient Atrial Fibrillation and Risk of Stroke after Acute Myocardial Infarction

Transient Atrial Fibrillation and Risk of Stroke after Acute Myocardial Infarction Transient Atrial Fibrillation and Risk of Stroke after Acute Myocardial Infarction Doron Aronson MD, Gregory Telman MD, Fadel BahouthMD, Jonathan Lessick MD, DSc and Rema Bishara MD Department of Cardiology

More information

CVD risk assessment using risk scores in primary and secondary prevention

CVD risk assessment using risk scores in primary and secondary prevention CVD risk assessment using risk scores in primary and secondary prevention Raul D. Santos MD, PhD Heart Institute-InCor University of Sao Paulo Brazil Disclosure Honoraria for consulting and speaker activities

More information

UPDATES IN MANAGEMENT OF HF

UPDATES IN MANAGEMENT OF HF UPDATES IN MANAGEMENT OF HF Jennifer R Brown MD, MS Heart Failure Specialist Medstar Cardiology Associates DC ACP Meeting Fall 2017 Disclosures: speaker bureau for novartis speaker bureau for actelion

More information

Guidelines on cardiovascular risk assessment and management

Guidelines on cardiovascular risk assessment and management European Heart Journal Supplements (2005) 7 (Supplement L), L5 L10 doi:10.1093/eurheartj/sui079 Guidelines on cardiovascular risk assessment and management David A. Wood 1,2 * 1 Cardiovascular Medicine

More information

(n=6279). Continuous variables are reported as mean with 95% confidence interval and T1 T2 T3. Number of subjects

(n=6279). Continuous variables are reported as mean with 95% confidence interval and T1 T2 T3. Number of subjects Table 1. Distribution of baseline characteristics across tertiles of OPG adjusted for age and sex (n=6279). Continuous variables are reported as mean with 95% confidence interval and categorical values

More information

Impact of coronary atherosclerotic burden on clinical presentation and prognosis of patients with coronary artery disease

Impact of coronary atherosclerotic burden on clinical presentation and prognosis of patients with coronary artery disease Impact of coronary atherosclerotic burden on clinical presentation and prognosis of patients with coronary artery disease Gjin Ndrepepa, Tomohisa Tada, Massimiliano Fusaro, Lamin King, Martin Hadamitzky,

More information

Risk Stratification of ACS Patients. Frans Van de Werf, MD, PhD University of Leuven, Belgium

Risk Stratification of ACS Patients. Frans Van de Werf, MD, PhD University of Leuven, Belgium Risk Stratification of ACS Patients Frans Van de Werf, MD, PhD University of Leuven, Belgium Which type of ACS patients are we talking about to day? 4/14/2011 STEMI and NSTEMI in the NRMI registry from

More information

Timing of NT-pro-BNP sampling for predicting adverse outcome after acute pulmonary embolism

Timing of NT-pro-BNP sampling for predicting adverse outcome after acute pulmonary embolism 7 Frederikus A. Klok Noortje van der Bijl Inge C.M. Mos Albert de Roos Lucia J. M. Kroft Menno V. Huisman Timing of NT-pro-BNP sampling for predicting adverse outcome after acute pulmonary embolism Letter

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Kavousi M, Leening MJG, Nanchen D, et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines

More information

Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept.

Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept. Obesity as a risk factor for Atrial Fibrillation Prof. Samir Morcos Rafla Alexandria Univ. Cardiology Dept. CardioAlex 2010 smrafla@hotmail.com 1 Obesity has reached epidemic proportions in the United

More information

Digoxin And Mortality in Patients With Atrial Fibrillation With and Without Heart Failure: Does Serum Digoxin Concentration Matter?

Digoxin And Mortality in Patients With Atrial Fibrillation With and Without Heart Failure: Does Serum Digoxin Concentration Matter? Digoxin And Mortality in Patients With Atrial Fibrillation With and Without Heart Failure: Does Serum Digoxin Concentration Matter? Renato D. Lopes, MD, PhD, FACC on behalf of the ARISTOTLE Investigators

More information

Copeptin in heart failure: Associations with clinical characteristics and prognosis

Copeptin in heart failure: Associations with clinical characteristics and prognosis Copeptin in heart failure: Associations with clinical characteristics and prognosis D. Berliner, N. Deubner, W. Fenske, S. Brenner, G. Güder, B. Allolio, R. Jahns, G. Ertl, CE. Angermann, S. Störk for

More information

Clinical Chemistry 62: (2016) Lipids, Lipoproteins, and Cardiovascular Risk Factors

Clinical Chemistry 62: (2016) Lipids, Lipoproteins, and Cardiovascular Risk Factors Clinical Chemistry 62:7 982 992 (2016) Lipids, Lipoproteins, and Cardiovascular Risk Factors Growth Differentiation Factor 15, Its 12-Month Relative Change, and Risk of Cardiovascular Events and Total

More information

Cost-effectiveness of pravastatin for primary prevention of coronary artery disease in Japan Nagata-Kobayashi S, Shimbo T, Matsui K, Fukui T

Cost-effectiveness of pravastatin for primary prevention of coronary artery disease in Japan Nagata-Kobayashi S, Shimbo T, Matsui K, Fukui T Cost-effectiveness of pravastatin for primary prevention of coronary artery disease in Japan Nagata-Kobayashi S, Shimbo T, Matsui K, Fukui T Record Status This is a critical abstract of an economic evaluation

More information

An Update & Suggestions on How to Use It

An Update & Suggestions on How to Use It Information as of November 2014 NT-proBNP NT-proBNP may be used to help detect, diagnose and evaluate the severity of heart failure. An Update & Suggestions on How to Use It ExamOne s NT-proBNP Experience

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Valle JA, Tamez H, Abbott JD, et al. Contemporary use and trends in unprotected left main coronary artery percutaneous coronary intervention in the United States: an analysis

More information

Risk modeling for Breast-Specific outcomes, CVD risk, and overall mortality in Alliance Clinical Trials of Breast Cancer

Risk modeling for Breast-Specific outcomes, CVD risk, and overall mortality in Alliance Clinical Trials of Breast Cancer Risk modeling for Breast-Specific outcomes, CVD risk, and overall mortality in Alliance Clinical Trials of Breast Cancer Mary Beth Terry, PhD Department of Epidemiology Mailman School of Public Health

More information

Improving Diagnostic, Prognostic & Therapeutic Biomarkers in Heart Disease. Professor Mark Richards Medicine, University of Otago, Christchurch

Improving Diagnostic, Prognostic & Therapeutic Biomarkers in Heart Disease. Professor Mark Richards Medicine, University of Otago, Christchurch Improving Diagnostic, Prognostic & Therapeutic Biomarkers in Heart Disease Professor Mark Richards Medicine, University of Otago, Christchurch BNP / NT-ProBNP H 2 N 1 Pro-BNP Cardiomyocyte 76 77 108 COOH

More information

The JUPITER trial: What does it tell us? Alice Y.Y. Cheng, MD, FRCPC January 24, 2009

The JUPITER trial: What does it tell us? Alice Y.Y. Cheng, MD, FRCPC January 24, 2009 The JUPITER trial: What does it tell us? Alice Y.Y. Cheng, MD, FRCPC January 24, 2009 Learning Objectives 1. Understand the role of statin therapy in the primary and secondary prevention of stroke 2. Explain

More information

Biomarkers and Arrhythmias/Devices Ulrika Birgersdotter-Green, M.D.

Biomarkers and Arrhythmias/Devices Ulrika Birgersdotter-Green, M.D. Biomarkers and Arrhythmias/Devices Ulrika Birgersdotter-Green, M.D. Professor of Medicine Division of Cardiology University of California, San Diego Disclosures Honoraria, Research Grants, Medtronic Honoraria,

More information

New insights in stent thrombosis: Platelet function monitoring. Franz-Josef Neumann Herz-Zentrum Bad Krozingen

New insights in stent thrombosis: Platelet function monitoring. Franz-Josef Neumann Herz-Zentrum Bad Krozingen New insights in stent thrombosis: Platelet function monitoring Franz-Josef Neumann Herz-Zentrum Bad Krozingen New insights in stent thrombosis: Platelet function monitoring Variability of residual platelet

More information

SUPPLEMENTAL MATERIAL

SUPPLEMENTAL MATERIAL SUPPLEMENTAL MATERIAL Table S1: Number and percentage of patients by age category Distribution of age Age

More information

TROPONINS HAVE THEY CHANGED YOUR

TROPONINS HAVE THEY CHANGED YOUR TROPONINS HAVE THEY CHANGED YOUR PRACTICE THIS WEEK? Harvey White John Neutze Scholar Green Lane Cardiovascular Service and Cardiovascular Research Unit Auckland City Hospital, Auckland, New Zealand Disclosure

More information

Quality Payment Program: Cardiology Specialty Measure Set

Quality Payment Program: Cardiology Specialty Measure Set Quality Payment Program: Cardiology Specialty Set Title Number CMS Reporting Method(s) Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for

More information

Stroke secondary prevention. Gill Cluckie Stroke Nurse Consultant St. George s Hospital

Stroke secondary prevention. Gill Cluckie Stroke Nurse Consultant St. George s Hospital Stroke secondary prevention Gill Cluckie Stroke Nurse Consultant St. George s Hospital Stroke recurrence The risk of recurrent stroke is greatest after first stroke 2 3% of survivors of a first stroke

More information

Clinical Trial Synopsis TL-OPI-518, NCT#

Clinical Trial Synopsis TL-OPI-518, NCT# Clinical Trial Synopsis, NCT# 00225264 Title of Study: A Double-Blind, Randomized, Comparator-Controlled Study in Subjects With Type 2 Diabetes Mellitus Comparing the Effects of Pioglitazone HCl vs Glimepiride

More information

Periprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion

Periprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion Periprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion Hyeon-Cheol Gwon Cardiac and Vascular Center Samsung Medical Center Sungkyunkwan University School of Medicine Dr. Hyeon-Cheol

More information

DECLARATION OF CONFLICT OF INTEREST

DECLARATION OF CONFLICT OF INTEREST DECLARATION OF CONFLICT OF INTEREST Probing prognosis in heart failure Daniel R. Wagner CHL/INCCI/CRP-Santé Luxembourg Disclosures Grants: Cordis, Boston Scientific, Medtronic, Sorin, Hexacath, Abbott,

More information

Post Hoc Analysis of the PARADIGM Heart Failure Trial:

Post Hoc Analysis of the PARADIGM Heart Failure Trial: Post Hoc Analysis of the PARADIGM Heart Failure Trial: Pulse Pressure and Outcomes in Heart Failure with Reduced Ejection Fraction Chen-Huan Chen, M.D. Professor, Department of Medicine, National Yang-Ming

More information

Blood Pressure Targets in Diabetes

Blood Pressure Targets in Diabetes Stockholm, 29 th August 2010 ESC Meeting Blood Pressure Targets in Diabetes Peter M Nilsson, MD, PhD Department of Clinical Sciences University Hospital, Malmö Sweden Studies on BP in DM2 ADVANCE RCT (Lancet

More information

Low-density lipoproteins cause atherosclerotic cardiovascular disease (ASCVD) 1. Evidence from genetic, epidemiologic and clinical studies

Low-density lipoproteins cause atherosclerotic cardiovascular disease (ASCVD) 1. Evidence from genetic, epidemiologic and clinical studies Low-density lipoproteins cause atherosclerotic cardiovascular disease (ASCVD) 1. Evidence from genetic, epidemiologic and clinical studies A Consensus Statement from the European Atherosclerosis Society

More information

Οξεία καρδιακή ανεπάρκεια: Ποιες παράμετροι συμβάλλουν στη διαστρωμάτωση κινδύνου των ασθενών;

Οξεία καρδιακή ανεπάρκεια: Ποιες παράμετροι συμβάλλουν στη διαστρωμάτωση κινδύνου των ασθενών; Οξεία καρδιακή ανεπάρκεια: Ποιες παράμετροι συμβάλλουν στη διαστρωμάτωση κινδύνου των ασθενών; Γ. Φιλιππάτος, MD, FACC, FESC, FCCP Επ. Καθηγητής Καρδιολογίας Πανεπ. Αθηνών Clinical Outcomes in Patients

More information

Clinical Investigations

Clinical Investigations Clinical Investigations Predictors of 30-Day Readmission in Patients Hospitalized With Decompensated Heart Failure Address for correspondence: Gian M. Novaro, MD, Department of Cardiology, Cleveland Clinic

More information

The Clinical Unmet need in the patient with Diabetes and ACS

The Clinical Unmet need in the patient with Diabetes and ACS The Clinical Unmet need in the patient with Diabetes and ACS Professor Kausik Ray (UK) BSc(hons), MBChB, MD, MPhil, FRCP (lon), FRCP (ed), FACC, FESC, FAHA Diabetes is a global public health challenge

More information

What have We Learned in Dyslipidemia Management Since the Publication of the 2013 ACC/AHA Guideline?

What have We Learned in Dyslipidemia Management Since the Publication of the 2013 ACC/AHA Guideline? What have We Learned in Dyslipidemia Management Since the Publication of the 2013 ACC/AHA Guideline? Salim S. Virani, MD, PhD, FACC, FAHA Associate Professor, Section of Cardiovascular Research Baylor

More information

Revascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing

Revascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing Revascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing Evidence and Uncertainties Robert O. Bonow, MD, MS, MACC Northwestern University Feinberg School of Medicine

More information

Ticagrelor compared with clopidogrel in patients with acute coronary syndromes the PLATO trial

Ticagrelor compared with clopidogrel in patients with acute coronary syndromes the PLATO trial compared with clopidogrel in patients with acute coronary syndromes the PLATO trial August 30, 2009 at 08.00 CET PLATO background In NSTE-ACS and STEMI, current guidelines recommend 12 months aspirin and

More information

Quality Payment Program: Cardiology Specialty Measure Set

Quality Payment Program: Cardiology Specialty Measure Set Measure Title * Reportable via PINNACLE α Reportable via Diabetes Collaborative CQMC v1.0 Measure High Priority Measure Cross Cutting Measure Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor

More information

Improved control for confounding using propensity scores and instrumental variables?

Improved control for confounding using propensity scores and instrumental variables? Improved control for confounding using propensity scores and instrumental variables? Dr. Olaf H.Klungel Dept. of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences

More information

Table S1: Diagnosis and Procedure Codes Used to Ascertain Incident Hip Fracture

Table S1: Diagnosis and Procedure Codes Used to Ascertain Incident Hip Fracture Technical Appendix Table S1: Diagnosis and Procedure Codes Used to Ascertain Incident Hip Fracture and Associated Surgical Treatment ICD 9 Code Descriptions Hip Fracture 820.XX Fracture neck of femur 821.XX

More information

Antihypertensive Trial Design ALLHAT

Antihypertensive Trial Design ALLHAT 1 U.S. Department of Health and Human Services Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic National Institutes

More information

BioRemarkable Symposium

BioRemarkable Symposium Autor Kurztitel der Präsentation Nr. 1 BioRemarkable Symposium The Use of High/Ultra Sensitivity Troponin as Cardiac Risk Marker in the Population Stefan Blankenberg University Heart Center Hamburg London,

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Pedersen SB, Langsted A, Nordestgaard BG. Nonfasting mild-to-moderate hypertriglyceridemia and risk of acute pancreatitis. JAMA Intern Med. Published online November 7, 2016.

More information

Glycemic index, glycemic load, and the risk of acute myocardial infarction in middle-aged Finnish men:

Glycemic index, glycemic load, and the risk of acute myocardial infarction in middle-aged Finnish men: Glycemic index, glycemic load, and the risk of acute myocardial infarction in middle-aged Finnish men: The Kuopio Ischaemic Heart Disease Risk Factor Study Jaakko Mursu, Jyrki K. Virtanen, Tiina H. Rissanen,

More information

J-curve Revisited. An Analysis of Blood Pressure and Cardiovascular Events in the Treating to New Targets (TNT) Trial

J-curve Revisited. An Analysis of Blood Pressure and Cardiovascular Events in the Treating to New Targets (TNT) Trial J-curve Revisited An Analysis of Blood Pressure and Cardiovascular Events in the Treating to New Targets (TNT) Trial Sripal Bangalore, MD, MHA, Franz H Messerli, MD, Chuan-Chuan Wun, PhD, Andrea L. Zuckerman,

More information

The target blood pressure in patients with diabetes is <130 mm Hg

The target blood pressure in patients with diabetes is <130 mm Hg Controversies in hypertension, About Diabetes diabetes and and metabolic Cardiovascular syndrome Risk ESC annual congress August 29, 2011 The target blood pressure in patients with diabetes is

More information

Supplementary Appendix

Supplementary Appendix Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Weintraub WS, Grau-Sepulveda MV, Weiss JM, et al. Comparative

More information

Supplementary Table 1. Baseline Characteristics by Quintiles of Systolic and Diastolic Blood Pressures

Supplementary Table 1. Baseline Characteristics by Quintiles of Systolic and Diastolic Blood Pressures Supplementary Data Supplementary Table 1. Baseline Characteristics by Quintiles of Systolic and Diastolic Blood Pressures Quintiles of Systolic Blood Pressure Quintiles of Diastolic Blood Pressure Q1 Q2

More information

Repeat ischaemic heart disease audit of primary care patients ( ): Comparisons by age, sex and ethnic group

Repeat ischaemic heart disease audit of primary care patients ( ): Comparisons by age, sex and ethnic group Repeat ischaemic heart disease audit of primary care patients (2002-2003): Comparisons by age, sex and ethnic group Baseline-repeat ischaemic heart disease audit of primary care patients: a comparison

More information

Novel Risk Markers in ACS (Hyperglycemia, Anemia, GFR)

Novel Risk Markers in ACS (Hyperglycemia, Anemia, GFR) Novel Risk Markers in ACS (Hyperglycemia, Anemia, GFR) Shaul Atar, MD Department of Cardiology Faculty of Medicine of the Galilee Western Galilee Medical Center, Nahariya, Israel TIMI Risk Score Age 65

More information

The TNT Trial Is It Time to Shift Our Goals in Clinical

The TNT Trial Is It Time to Shift Our Goals in Clinical The TNT Trial Is It Time to Shift Our Goals in Clinical Angioplasty Summit Luncheon Symposium Korea Assoc Prof David Colquhoun 29 April 2005 University of Queensland, Wesley Hospital, Brisbane, Australia

More information

Correlation of novel cardiac marker

Correlation of novel cardiac marker Correlation of novel cardiac marker and mortality in EGAT population. Soluble ST2 hscrp Poh Chanyavanich, MD SukitYamwong, MD Piyamitr Sritara, MD Ramathibodi hospital Background hscrp - the most widely

More information

Aspirin Resistance in Patients with Chronic Renal Failure (P 5325)

Aspirin Resistance in Patients with Chronic Renal Failure (P 5325) Aspirin Resistance in Patients with Chronic Renal Failure (P 5325) Beste Ozben Sadic 1, Azra Tanrikulu 1, Mehmet Koc 2, Tomris Ozben 3, Oguz Caymaz 1 1 Marmara University, Faculty of Medicine, Department

More information

How will new high sensitive troponins affect the criteria?

How will new high sensitive troponins affect the criteria? How will new high sensitive troponins affect the criteria? Hugo A Katus MD Abteilung Innere Medizin III Kardiologie, Angiologie, Pulmologie Universitätsklinikum Heidelberg Even more sensitive: The new

More information

GSK Medicine: Study Number: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives:

GSK Medicine: Study Number: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.

More information

Early risk stratification is essential in the management of

Early risk stratification is essential in the management of Cystatin C A Novel Predictor of Outcome in Suspected or Confirmed Non ST-Elevation Acute Coronary Syndrome Tomas Jernberg, MD, PhD; Bertil Lindahl, MD, PhD; Stefan James, MD, PhD; Anders Larsson, MD, PhD;

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Åsvold BO, Vatten LJ, Bjøro T, et al; Thyroid Studies Collaboration. Thyroid function within the normal range and risk of coronary heart disease: an individual participant

More information

Table S1. Read and ICD 10 diagnosis codes for polymyalgia rheumatica and giant cell arteritis

Table S1. Read and ICD 10 diagnosis codes for polymyalgia rheumatica and giant cell arteritis SUPPLEMENTARY MATERIAL TEXT Text S1. Multiple imputation TABLES Table S1. Read and ICD 10 diagnosis codes for polymyalgia rheumatica and giant cell arteritis Table S2. List of drugs included as immunosuppressant

More information

Supplementary appendix

Supplementary appendix Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Cholesterol Treatment Trialists Collaboration.

More information

Statistical Fact Sheet Populations

Statistical Fact Sheet Populations Statistical Fact Sheet Populations At-a-Glance Summary Tables Men and Cardiovascular Diseases Mexican- American Males Diseases and Risk Factors Total Population Total Males White Males Black Males Total

More information

Lipoprotein(a), PCSK9 Inhibition and Cardiovascular Risk: Insights from the FOURIER Trial

Lipoprotein(a), PCSK9 Inhibition and Cardiovascular Risk: Insights from the FOURIER Trial Lipoprotein(a), PCSK9 Inhibition and Cardiovascular Risk: Insights from the FOURIER Trial Michelle L. O Donoghue, Robert P. Giugliano, Anthony C. Keech, Estella Kanevsky, KyungAh Im, Peter S. Sever, Terje

More information

ESC Geoffrey Rose Lecture on Population Sciences Cholesterol and risk: past, present and future

ESC Geoffrey Rose Lecture on Population Sciences Cholesterol and risk: past, present and future ESC Geoffrey Rose Lecture on Population Sciences Cholesterol and risk: past, present and future Rory Collins BHF Professor of Medicine & Epidemiology Clinical Trial Service Unit & Epidemiological Studies

More information

Program Metrics. New Unique ID. Old Unique ID. Metric Set Metric Name Description. Old Metric Name

Program Metrics. New Unique ID. Old Unique ID. Metric Set Metric Name Description. Old Metric Name Program Metrics The list below includes the metrics that will be calculated by the PINNACLE Registry for the outpatient office setting. These include metrics for, Atrial Fibrillation, Hypertension and.

More information

Treatment Of Preserved Cardiac Function Heart Failure with an Aldosterone antagonist (TOPCAT) AHA Nov 18, 2014 Update on Randomized Trials

Treatment Of Preserved Cardiac Function Heart Failure with an Aldosterone antagonist (TOPCAT) AHA Nov 18, 2014 Update on Randomized Trials Treatment Of Preserved Cardiac Function Heart Failure with an Aldosterone antagonist (TOPCAT) AHA Nov 18, 2014 Update on Randomized Trials Marc A. Pfeffer, MD, PhD; Brian Claggett, PhD; Susan F. Assmann,

More information

Seung-Jae Lee, 1 Dong-Geun Lee, 1 Dal-Soo Lim, 2 Sukkeun Hong, 2 and Jin-Sik Park Methods. 1. Introduction

Seung-Jae Lee, 1 Dong-Geun Lee, 1 Dal-Soo Lim, 2 Sukkeun Hong, 2 and Jin-Sik Park Methods. 1. Introduction Disease Markers Volume 2015, Article ID 597570, 5 pages http://dx.doi.org/10.1155/2015/597570 Research Article Difference in the Prognostic Significance of N-Terminal Pro-B-Type Natriuretic Peptide between

More information

Models of preventive care in clinical practice to achieve 25 by 25

Models of preventive care in clinical practice to achieve 25 by 25 Models of preventive care in clinical practice to achieve 25 by 25 Professor David A Wood Garfield Weston Professor of Cardiovascular Medicine International Centre for Circulatory Health Imperial College

More information