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?

Michael H. Olsen, Thomas Sehestedt, Stig Lyngbæk, Tine W. Hansen, Susanne Rasmussen, Kristian Wachtell, Christian Torp-Pedersen, Per R. Hildebrandt, Hans Ibsen

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    Abstrakt

    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.

    OriginalsprogEngelsk
    Sider (fra-til)134-139
    Antal sider6
    TidsskriftCurrent Vascular Pharmacology
    Vol/bind8
    Udgave nummer1
    DOI
    StatusUdgivet - 1 jan. 2010

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