Cited by 482GDF15 and Related BiomarkersHeart Failure Treatment and ManagementAcute Myocardial Infarction Research

Prognostic Utility of Novel Biomarkers of Cardiovascular Stress: The Framingham Heart Study

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Wang, Thomas J., Wollert, Kai C., Larson, Martin G., Coglianese, Erin, McCabe, Elizabeth L., Cheng, Susan, Ho, Jennifer E., Fradley, Michael G. +7 more·2012·Circulation

Abstract

BACKGROUND: Biomarkers for predicting cardiovascular events in community-based populations have not consistently added information to standard risk factors. A limitation of many previously studied biomarkers is their lack of cardiovascular specificity. METHODS AND RESULTS: To determine the prognostic value of 3 novel biomarkers induced by cardiovascular stress, we measured soluble ST2, growth differentiation factor-15, and high-sensitivity troponin I in 3428 participants (mean age, 59 years; 53% women) in the Framingham Heart Study. We performed multivariable-adjusted proportional hazards models to assess the individual and combined ability of the biomarkers to predict adverse outcomes. We also constructed a "multimarker" score composed of the 3 biomarkers in addition to B-type natriuretic peptide and high-sensitivity C-reactive protein. During a mean follow-up of 11.3 years, there were 488 deaths, 336 major cardiovascular events, 162 heart failure events, and 142 coronary events. In multivariable-adjusted models, the 3 new biomarkers were associated with each end point (P<0.001) except coronary events. Individuals with multimarker scores in the highest quartile had a 3-fold risk of death (adjusted hazard ratio, 3.2; 95% confidence interval, 2.2-4.7; P<0.001), 6-fold risk of heart failure (6.2; 95% confidence interval, 2.6-14.8; P<0.001), and 2-fold risk of cardiovascular events (1.9; 95% confidence interval, 1.3-2.7; P=0.001). Addition of the multimarker score to clinical variables led to significant increases in the c statistic (P=0.005 or lower) and net reclassification improvement (P=0.001 or lower). CONCLUSION: Multiple biomarkers of cardiovascular stress are detectable in ambulatory individuals and add prognostic value to standard risk factors for predicting death, overall cardiovascular events, and heart failure.

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  1. [29]Ky B French B McCloskey K Rame JE McIntosh E Shahi P Dries DL Tang WH Wu AH Fang JC Boxer R Sweitzer NK Levy WC Goldberg LR Jessup M Cappola TP High-sensitivity st2 for prediction of adverse outcomes in chronic heart failure Circ Heart Fail 2012 4 180 187 21178018 PMC3163169

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Authors
Wang, T. J., Wollert, K. C., Larson, M. G., Coglianese, E., McCabe, E. L., Cheng, S., Ho, J. E., Fradley, M. G., Ghorbani, A., Xanthakis, V., Kempf, T., Benjamin, E. J., Levy, D., Vasan, R. S., & Januzzi, J. L.
Affiliations
Boston University (US)
Venue
Circulation
Published
2012-09-25
Volume
126
Issue
13
Pages
1596-1604
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2163917890
Cited by
482
References
65
Citations by year
2026: 16 · 2025: 16 · 2024: 29 · 2023: 33 · 2022: 25 · 2021: 32 · 2020: 40 · 2019: 42 · 2018: 31 · 2017: 42 · 2016: 45 · 2015: 38 · 2014: 44 · 2013: 43 · 2012: 6
FWCI
32.23
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (n01hc25195-41-0-1)
  • National Heart, Lung, and Blood Institute (R01HL086875, N01‐HC25195, K99HL107642, R01-HL-08675, N01-HC-025195)
Topics
  • Health Sciences › Medicine › Rheumatology › GDF15 and Related Biomarkers
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
soluble ST2, growth differentiation factor 15, high-sensitivity troponin I, cardiovascular mortality, heart failure, major cardiovascular events, brain natriuretic peptide, C-reactive protein, prognostic value, Framingham Heart Study
MeSH terms
Interleukin-1 Receptor-Like 1 Protein, Aged, C-Reactive Protein, Cardiovascular Diseases, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Prognosis, Receptors, Cell Surface, Retrospective Studies, Risk Factors, Biomarkers, Proportional Hazards Models, Troponin I, Natriuretic Peptide, Brain, Growth Differentiation Factor 15

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