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Cardiovascular biomarkers predict fragility fractures in older adults.

https://arctichealth.org/en/permalink/ahliterature299736
Source
Heart. 2019 03; 105(6):449-454
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2019
Author
Madeleine Johansson
Fabrizio Ricci
Giuseppe Di Martino
Cecilia Rogmark
Richard Sutton
Viktor Hamrefors
Olle Melander
Artur Fedorowski
Author Affiliation
Department of Clinical Sciences, Faculty of Medicine, Clinical Research Center, Lund University, Malmö, Sweden.
Source
Heart. 2019 03; 105(6):449-454
Date
03-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adrenomedullin - blood
Aged
Atrial Natriuretic Factor - blood
Biomarkers - blood
Body mass index
Cardiovascular System - metabolism
Cohort Studies
Correlation of Data
Endothelin-1 - blood
Female
Fractures, Bone - blood
Humans
Independent Living - statistics & numerical data
Male
Middle Aged
Peptide Fragments - blood
Prospective Studies
Protein Precursors - blood
Reproducibility of Results
Risk assessment
Risk factors
Sweden
Vasopressins - blood
Abstract
To assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.
We analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.
Overall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p
Notes
CommentIn: Heart. 2019 Mar;105(6):427-428 PMID 30361269
PubMed ID
30322844 View in PubMed
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Changes in natriuretic peptides, apelin and adrenomedullin after off-pump and on-pump coronary artery bypass surgery.

https://arctichealth.org/en/permalink/ahliterature91025
Source
J Cardiovasc Surg (Torino). 2008 Dec;49(6):783-91
Publication Type
Article
Date
Dec-2008
Author
Mahar M A A
Rainio A.
Ilves M.
Lindgren K.
Kärjä-Koskenkari P.
Taskinen P.
Vuolteenaho O.
Biancari F.
Author Affiliation
Division of Cardiothoracic and Vascular Surgery, Department of Surgery, University of Oulu, Oulu, Finland.
Source
J Cardiovasc Surg (Torino). 2008 Dec;49(6):783-91
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Adrenomedullin - blood
Aged
Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump
Creatinine - blood
Female
Humans
Intercellular Signaling Peptides and Proteins - blood
Male
Middle Aged
Natriuretic Peptides - blood
Troponin I - blood
Abstract
AIM: The authors have evaluated the postoperative changes of natriuretic peptides, apelin and adrenomedullin after off-pump (OPCAB) and on-pump coronary artery bypass surgery (CCAB) to assess the impact of these techniques on the myocardium. METHODS: Twenty-two patients underwent OPCAB and 24 patients underwent CCAB. Plasma levels of NT-proANP, NT-proBNP, apelin and adrenomedullin were measured preoperatively, and on the 1st, 3rd, and 5th postoperative day. RESULTS: Natriuretic peptides, apelin and adrenomedullin increased significantly postoperatively. Natriuretic peptides were markedly elevated on the fifth postoperative day. Apelin was still increasing, but adrenomedullin, although elevated, clearly decreased toward baseline levels on the fifth postoperative day. CCAB was associated with significantly higher postoperative cTnI, but levels of natriuretic peptides, adrenomedullin and apelin did not differ significantly after CCAB and OPCAB. cTnI, echocardiographic parameters, cardiac index, and degree of postoperative pericardial effusion did not correlate with levels of natriuretic peptides, apelin and adrenomedullin. Postoperative levels of natriuretic peptides were significantly associated with parameters of renal function, age, and extracardiac arteriopathy. The correlation between preoperative estimated glomerular filtration rate and natriuretic peptides increased along the study intervals (NT-proANP rho: -0.181, -0.350, -0.364, and -0.442; NT-proBNP rho: -0.112, -0.420, -0.405 and -0.550). Also adrenomedullin correlated with parameters of renal function. The postoperative levels of apelin were not associated with any variable. CONCLUSION: A marked, sustained and similar increase in these five markers of cardiac adaptation was detected after OPCAB and CCAB. The upregulation of these peptides should be further investigated to evaluate their potential beneficial/harmful impact on the outcome after coronary surgery.
PubMed ID
19043392 View in PubMed
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Novel and conventional biomarkers for prediction of incident cardiovascular events in the community.

https://arctichealth.org/en/permalink/ahliterature88532
Source
JAMA. 2009 Jul 1;302(1):49-57
Publication Type
Article
Date
Jul-1-2009
Author
Melander Olle
Newton-Cheh Christopher
Almgren Peter
Hedblad Bo
Berglund Göran
Engström Gunnar
Persson Margaretha
Smith J Gustav
Magnusson Martin
Christensson Anders
Struck Joachim
Morgenthaler Nils G
Bergmann Andreas
Pencina Michael J
Wang Thomas J
Author Affiliation
Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö University Hospital, SE 205 02 Malmö, Sweden. olle.melander@med.lu.se
Source
JAMA. 2009 Jul 1;302(1):49-57
Date
Jul-1-2009
Language
English
Publication Type
Article
Keywords
Adrenomedullin - blood
Atrial Natriuretic Factor - blood
Biological Markers - blood
C-Reactive Protein - metabolism
Cardiovascular Diseases - blood - epidemiology
Cohort Studies
Cystatin C - blood
Female
Humans
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Proportional Hazards Models
Risk assessment
Risk factors
Abstract
CONTEXT: Prior studies have demonstrated conflicting results regarding how much information novel biomarkers add to cardiovascular risk assessment. OBJECTIVE: To evaluate the utility of contemporary biomarkers for predicting cardiovascular risk when added to conventional risk factors. DESIGN, SETTING, AND PARTICIPANTS: Cohort study of 5067 participants (mean age, 58 years; 60% women) without cardiovascular disease from Malm?, Sweden, who attended a baseline examination between 1991 and 1994. Participants underwent measurement of C-reactive protein (CRP), cystatin C, lipoprotein-associated phospholipase 2, midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide, and N-terminal pro-B-type natriuretic peptide (N-BNP) and underwent follow-up until 2006 using the Swedish national hospital discharge and cause-of-death registers and the Stroke in Malm? register for first cardiovascular events (myocardial infarction, stroke, coronary death). MAIN OUTCOME MEASURES: Incident cardiovascular and coronary events. RESULTS: During median follow-up of 12.8 years, there were 418 cardiovascular and 230 coronary events. Models with conventional risk factors had C statistics of 0.758 (95% confidence interval [CI], 0.734 to 0.781) and 0.760 (0.730 to 0.789) for cardiovascular and coronary events, respectively. Biomarkers retained in backward-elimination models were CRP and N-BNP for cardiovascular events and MR-proADM and N-BNP for coronary events, which increased the C statistic by 0.007 (P = .04) and 0.009 (P = .08), respectively. The proportion of participants reclassified was modest (8% for cardiovascular risk, 5% for coronary risk). Net reclassification improvement was nonsignificant for cardiovascular events (0.0%; 95% CI, -4.3% to 4.3%) and coronary events (4.7%; 95% CI, -0.76% to 10.1%). Greater improvements were observed in analyses restricted to intermediate-risk individuals (cardiovascular events: 7.4%; 95% CI, 0.7% to 14.1%; P = .03; coronary events: 14.6%; 95% CI, 5.0% to 24.2%; P = .003). However, correct reclassification was almost entirely confined to down-classification of individuals without events rather than up-classification of those with events. CONCLUSIONS: Selected biomarkers may be used to predict future cardiovascular events, but the gains over conventional risk factors are minimal. Risk classification improved in intermediate-risk individuals, mainly through the identification of those unlikely to develop events.
Notes
Comment In: JAMA. 2009 Jul 1;302(1):92-319567447
PubMed ID
19567439 View in PubMed
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Predictive value of midregional pro-adrenomedullin compared to natriuretic peptides for incident cardiovascular disease and heart failure in the population-based FINRISK 1997 cohort.

https://arctichealth.org/en/permalink/ahliterature259380
Source
Ann Med. 2014 May;46(3):155-62
Publication Type
Article
Date
May-2014
Author
Anne Funke-Kaiser
Aki S Havulinna
Tanja Zeller
Sebastian Appelbaum
Pekka Jousilahti
Erkki Vartiainen
Stefan Blankenberg
Karsten Sydow
Veikko Salomaa
Source
Ann Med. 2014 May;46(3):155-62
Date
May-2014
Language
English
Publication Type
Article
Keywords
Adrenomedullin - blood
Adult
Aged
C-Reactive Protein - metabolism
Female
Finland
Heart Failure - blood - diagnosis
Humans
Longitudinal Studies
Male
Middle Aged
Natriuretic Peptides - blood
Predictive value of tests
Protein Precursors - blood
Abstract
To examine whether midregional pro-adrenomedullin (MR-proADM) plasma concentrations predict incident cardiovascular outcomes in the general population. Natriuretic peptides (N-terminal pro-brain natriuretic peptide (NT-proBNP), B-type natriuretic peptide (BNP), and midregional pro-atrial natriuretic peptide (MR-proANP)) were analyzed for comparison.
MR-proADM plasma concentrations and those of the natriuretic peptides were determined in 8444 individuals of the FINRISK 1997 cohort. Patients were followed for 14 years (median). Cox regression analyses, discrimination, and reclassification analyses adjusting for Framingham risk factors were performed to evaluate the additional benefit from MR-proADM.
MR-proADM concentrations significantly predicted all-cause death (hazard ratio highest quintile versus lowest 1.18, 95% confidence interval 1.08-1.28), stroke (1.20, 1.05-1.38), major adverse cardiac events (MACE) (1.27, 1.17-1.37), and heart failure (1.67, 1.49-1.87). MR-proADM remained associated with MACE, death, and heart failure even after additional adjustment for NT-proBNP and C-reactive protein. Adding MR-proADM to the Framingham risk factors significantly improved discrimination (P
PubMed ID
24506434 View in PubMed
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Pro-atrial natriuretic peptide and prediction of atrial fibrillation and stroke: The Malmö Preventive Project.

https://arctichealth.org/en/permalink/ahliterature290258
Source
Eur J Prev Cardiol. 2017 05; 24(8):788-795
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-2017
Author
John Berntsson
J Gustav Smith
Peter M Nilsson
Bo Hedblad
Olle Melander
Gunnar Engström
Author Affiliation
1 Department of Clinical Sciences, Lund University, Sweden.
Source
Eur J Prev Cardiol. 2017 05; 24(8):788-795
Date
05-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adrenomedullin - blood
Age Factors
Aged
Atrial Fibrillation - blood - diagnosis - epidemiology
Biomarkers - blood
Female
Humans
Incidence
Male
Middle Aged
Peptide Fragments - blood
Predictive value of tests
Prognosis
Protein Precursors - blood
Risk assessment
Risk factors
Stroke - blood - diagnosis - epidemiology
Sweden - epidemiology
Time Factors
Up-Regulation
Abstract
Background The increasing prevalence of atrial fibrillation and novel therapeutic tools to prevent cardioembolic stroke has increased the need for risk markers. Objectives This study explored the relationship between the midregional sequence of pro-atrial natriuretic peptide (MR-proANP) levels with the risk of atrial fibrillation and stroke, and whether measurement of MR-proANP improves the prediction of these outcomes. Methods MR-proANP was measured in fasting blood samples of 5130 subjects (69% men, mean age 69.2?±?6.2 years) without a history of atrial fibrillation or stroke from the general population. The incidence of atrial fibrillation and stroke was monitored over a median follow-up of 5.6 years. C-statistics and net reclassification improvement was used to assess the predictive ability of MR-proANP in addition to conventional risk factors. Results Log-normalized MR-proANP was significantly associated with the incidence of atrial fibrillation ( n?=?362; hazard ratio (HR); 95% confidence interval (CI) per 1 standard deviation (SD) 2.05, 1.86-2.27) and stroke from all causes ( n?=?195; HR 1.30; 95% CI 1.12-1.50). The HR for stroke events related to atrial fibrillation was 1.79 (95% CI 1.25-2.58) per 1 SD. MR-proANP significantly improved the prediction of atrial fibrillation when added to a risk score of conventional risk factors (C statistic 0.69 vs. 0.75), mainly by down-classifying subjects who did not develop atrial fibrillation. A smaller improvement in predictive ability was observed for stroke (C statistic 0.66 vs. 0.68). Conclusion High plasma levels of MR-proANP are associated with the incidence of atrial fibrillation and stroke in the middle-aged and elderly population. MR-proANP may be useful to identify individuals with an increased risk of atrial fibrillation.
Notes
CommentIn: Eur J Prev Cardiol. 2017 Aug;24(12 ):1239-1241 PMID 28452559
PubMed ID
28195503 View in PubMed
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Pro-A-type natriuretic peptide, proadrenomedullin, and N-terminal pro-B-type natriuretic peptide used in a multimarker strategy in primary health care in risk assessment of patients with symptoms of heart failure.

https://arctichealth.org/en/permalink/ahliterature117675
Source
J Card Fail. 2013 Jan;19(1):31-9
Publication Type
Article
Date
Jan-2013
Author
Urban Alehagen
Ulf Dahlström
Jens F Rehfeld
Jens P Goetze
Author Affiliation
Division of Cardiovascular Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Department of Cardiology, University Hospital of Linköping, County Council of Östergötland, Linköping, Sweden. urban.alehagen@liu.se
Source
J Card Fail. 2013 Jan;19(1):31-9
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adrenomedullin - blood
Aged
Aged, 80 and over
Biological Markers - blood
Cohort Studies
Disease Progression
Female
Follow-Up Studies
Heart Failure - blood - mortality - physiopathology
Humans
Kaplan-Meier Estimate
Male
Natriuretic Peptide, Brain - blood
Normal Distribution
Peptide Fragments - blood
Primary Health Care
Proportional Hazards Models
Protein Precursors - blood
Risk assessment
Sensitivity and specificity
Survival Analysis
Sweden
Time Factors
Abstract
Use of new biomarkers in the handling of heart failure patients has been advocated in the literature, but most often in hospital-based populations. Therefore, we wanted to evaluate whether plasma measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), midregional pro-A-type natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM), individually or combined, gives prognostic information regarding cardiovascular and all-cause mortality that could motivate use in elderly patients presenting with symptoms suggestive of heart failure in primary health care.
The study included 470 elderly patients (mean age 73 years) with symptoms of heart failure in primary health care. All participants underwent clinical examination, 2-dimenstional echocardiography, and plasma measurement of the 3 propeptides and were followed for 13 years. All mortality was registered during the follow-up period. The 4th quartiles of the biomarkers were applied as cutoff values. NT-proBNP exhibited the strongest prognostic information with >4-fold increased risk for cardiovascular mortality within 5 years. For all-cause mortality MR-proADM exhibited almost 2-fold and NT-proBNP 3-fold increased risk within 5 years. In the 5-13-year perspective, NT-proBNP and MR-proANP showed significant and independent cardiovascular prognostic information. NT-proBNP and MR-proADM showed significant prognostic information regarding all-cause mortality during the same time. In those with ejection fraction (EF) 50% NT-proBNP exhibited >3-fold increased risk if analyzed as the only biomarker in the model. If instead the biomarkers were all below the cutoff value, the patients had a highly reduced mortality risk, which also could influence the handling of patients.
The 3 biomarkers could be integrated in a multimarker strategy for use in primary health care.
PubMed ID
23273592 View in PubMed
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Vasoactive peptides with angiogenesis-regulating activity predict cancer risk in males.

https://arctichealth.org/en/permalink/ahliterature127763
Source
Cancer Epidemiol Biomarkers Prev. 2012 Mar;21(3):513-22
Publication Type
Article
Date
Mar-2012
Author
Mattias Belting
Peter Almgren
Jonas Manjer
Bo Hedblad
Joachim Struck
Thomas J Wang
Andreas Bergmann
Olle Melander
Author Affiliation
Department of Clinical Sciences, Lund University, Section of Oncology, Lund, Sweden.
Source
Cancer Epidemiol Biomarkers Prev. 2012 Mar;21(3):513-22
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adrenomedullin - blood
Adult
Aged
Atrial Natriuretic Factor - blood
Case-Control Studies
Female
Follow-Up Studies
Glycopeptides - blood
Humans
Male
Middle Aged
Neoplasms - blood - epidemiology - etiology - mortality
Neovascularization, Pathologic
Peptide Fragments - blood
Prognosis
Prospective Studies
Protein Precursors - blood
Risk factors
Survival Rate
Sweden - epidemiology
Tumor Markers, Biological - blood
Abstract
Tumor development requires angiogenesis, and antiangiogenesis has been introduced in the treatment of cancer patients; however, how the cardiovascular phenotype correlates with cancer risk remains ill-defined. Here, we hypothesized that vasoactive peptides previously implicated in angiogenesis regulation predict long-term cancer risk.
We measured midregional proatrial natriuretic peptide (MR-proANP), proadrenomedullin (MR-proADM), and C-terminal preprovasopressin (copeptin) in fasting plasma from participants of the Malmö Diet and Cancer Study that were free from cancer prior to the baseline exam in 1991 to 1994 (1,768 males and 2,293 females). We used Cox proportional hazards models to determine the time to first cancer event in relation to baseline levels of vasoactive peptides during a median follow-up of 15 years.
First cancer events occurred in 366 males and in 368 females. In males, one SD increase of MR-proANP, copeptin, and MR-proADM was independently related to incident cancer [HR (95% CI)] by 0.85 (0.74-0.96), P = 0.012; 1.17 (1.04-1.32), P = 0.009; and 1.12 (0.99-1.26), P = 0.065, respectively, and a summed biomarker score identified an almost 2-fold difference in cancer risk between the top and bottom quartile (P
PubMed ID
22267286 View in PubMed
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8 records – page 1 of 1.