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Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease

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Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease. / Nadir, M. Adnan.; Rekhraj, Sushma; Wei, Li; Lim, Tiong.K.; Davidson, John; MacDonald, Thomas. M.; Lang, Chim C.; Dow, Ellie; Struthers, Allan. D. (Lead / Corresponding author).

In: Journal of the American College of Cardiology, Vol. 60, No. 11, 11.09.2012, p. 960-968.

Research output: Contribution to journalArticle

Harvard

Nadir, MA, Rekhraj, S, Wei, L, Lim, TK, Davidson, J, MacDonald, TM, Lang, CC, Dow, E & Struthers, AD 2012, 'Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease' Journal of the American College of Cardiology, vol 60, no. 11, pp. 960-968., 10.1016/j.jacc.2012.04.049

APA

Nadir, M. A., Rekhraj, S., Wei, L., Lim, T. K., Davidson, J., MacDonald, T. M., ... Struthers, A. D. (2012). Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease. Journal of the American College of Cardiology, 60(11), 960-968. 10.1016/j.jacc.2012.04.049

Vancouver

Nadir MA, Rekhraj S, Wei L, Lim TK, Davidson J, MacDonald TM et al. Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease. Journal of the American College of Cardiology. 2012 Sep 11;60(11):960-968. Available from: 10.1016/j.jacc.2012.04.049

Author

Nadir, M. Adnan.; Rekhraj, Sushma; Wei, Li; Lim, Tiong.K.; Davidson, John; MacDonald, Thomas. M.; Lang, Chim C.; Dow, Ellie; Struthers, Allan. D. (Lead / Corresponding author) / Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease.

In: Journal of the American College of Cardiology, Vol. 60, No. 11, 11.09.2012, p. 960-968.

Research output: Contribution to journalArticle

Bibtex - Download

@article{5db21bb2bec244d0bb48a6566e0fe4ea,
title = "Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease",
keywords = "biomarkers, Cardiovascular risk, Primary prevention",
author = "Nadir, {M. Adnan.} and Sushma Rekhraj and Li Wei and Tiong.K. Lim and John Davidson and MacDonald, {Thomas. M.} and Lang, {Chim C.} and Ellie Dow and Struthers, {Allan. D.}",
year = "2012",
doi = "10.1016/j.jacc.2012.04.049",
volume = "60",
number = "11",
pages = "960--968",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Improving the primary prevention of cardiovascular events by using biomarkers to identify individuals with silent heart disease

A1 - Nadir,M. Adnan.

A1 - Rekhraj,Sushma

A1 - Wei,Li

A1 - Lim,Tiong.K.

A1 - Davidson,John

A1 - MacDonald,Thomas. M.

A1 - Lang,Chim C.

A1 - Dow,Ellie

A1 - Struthers,Allan. D.

AU - Nadir,M. Adnan.

AU - Rekhraj,Sushma

AU - Wei,Li

AU - Lim,Tiong.K.

AU - Davidson,John

AU - MacDonald,Thomas. M.

AU - Lang,Chim C.

AU - Dow,Ellie

AU - Struthers,Allan. D.

PY - 2012/9/11

Y1 - 2012/9/11

N2 - <p>Objectives <br/> The aim of this study was to examine whether biomarkers can identify silent cardiac target organ damage (cTOD) in a primary prevention population.</p> <p>Background <br/> One possible way to improve primary prevention of cardiovascular events is to identify those patients who already harbor silent cTOD (i.e., myocardial ischemia, left ventricular hypertrophy, systolic dysfunction, diastolic dysfunction, or left atrial enlargement). This might be possible by screening with a biomarker (e.g. high sensitivity cardiac troponin T [hs-cTnT] or B-type natriuretic peptide [BNP]).</p> <p>Methods <br/> We prospectively recruited 300 asymptomatic individuals already receiving primary prevention therapy. Transthoracic echocardiography, stress echocardiography, and/or myocardial perfusion imaging were performed to identify silent cTOD.</p> <p>Results <br/> One hundred two (34%) patients had evidence of cTOD. Left ventricular hypertrophy was the most prevalent (29.7%) form of cTOD, followed by diastolic dysfunction (21.3%), left atrial enlargement (15.3%), systolic dysfunction (6.3%), and ischemia (6.3%). The area under the curve (AUC) for BNP to identify any form of silent cTOD was 0.78 overall and 0.82 in men. The equivalent figures for hs-cTnT were 0.70 and 0.75 in women. The AUC for BNP and hs-cTnT together was 0.81 and 0.82 in men. However, the discrimination power of other markers was poor, with AUCs of 0.61 for microalbuminuria, 0.49 for uric acid, and 0.58 for eGFR.</p> <p>Conclusions <br/> In asymptomatic treated primary prevention patients, BNP screening is able to identify existing silent cTOD. The performance of hs-cTnT was not as good as that of BNP. B-type natriuretic peptide plus hs-cTnT together performed best. Prescreening with BNP +/- cTnT followed by targeted phenotyping is worth exploring further as a possible way to improve primary prevention. (J Am Coll Cardiol 2012;60:960-8) (C) 2012 by the American College of Cardiology Foundation</p>

AB - <p>Objectives <br/> The aim of this study was to examine whether biomarkers can identify silent cardiac target organ damage (cTOD) in a primary prevention population.</p> <p>Background <br/> One possible way to improve primary prevention of cardiovascular events is to identify those patients who already harbor silent cTOD (i.e., myocardial ischemia, left ventricular hypertrophy, systolic dysfunction, diastolic dysfunction, or left atrial enlargement). This might be possible by screening with a biomarker (e.g. high sensitivity cardiac troponin T [hs-cTnT] or B-type natriuretic peptide [BNP]).</p> <p>Methods <br/> We prospectively recruited 300 asymptomatic individuals already receiving primary prevention therapy. Transthoracic echocardiography, stress echocardiography, and/or myocardial perfusion imaging were performed to identify silent cTOD.</p> <p>Results <br/> One hundred two (34%) patients had evidence of cTOD. Left ventricular hypertrophy was the most prevalent (29.7%) form of cTOD, followed by diastolic dysfunction (21.3%), left atrial enlargement (15.3%), systolic dysfunction (6.3%), and ischemia (6.3%). The area under the curve (AUC) for BNP to identify any form of silent cTOD was 0.78 overall and 0.82 in men. The equivalent figures for hs-cTnT were 0.70 and 0.75 in women. The AUC for BNP and hs-cTnT together was 0.81 and 0.82 in men. However, the discrimination power of other markers was poor, with AUCs of 0.61 for microalbuminuria, 0.49 for uric acid, and 0.58 for eGFR.</p> <p>Conclusions <br/> In asymptomatic treated primary prevention patients, BNP screening is able to identify existing silent cTOD. The performance of hs-cTnT was not as good as that of BNP. B-type natriuretic peptide plus hs-cTnT together performed best. Prescreening with BNP +/- cTnT followed by targeted phenotyping is worth exploring further as a possible way to improve primary prevention. (J Am Coll Cardiol 2012;60:960-8) (C) 2012 by the American College of Cardiology Foundation</p>

KW - biomarkers

KW - Cardiovascular risk

KW - Primary prevention

UR - http://www.scopus.com/inward/record.url?scp=84865735022&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2012.04.049

DO - 10.1016/j.jacc.2012.04.049

M1 - Article

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 11

VL - 60

SP - 960

EP - 968

ER -

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