1. Multiple biomarkers for mortality prediction in peripheral arterial disease
- Author
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Stephen M. Amrock and Michael Weitzman
- Subjects
Male ,Time Factors ,Homocysteine ,Arterial disease ,Neutrophils ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Disease ,030204 cardiovascular system & hematology ,Bioinformatics ,chemistry.chemical_compound ,0302 clinical medicine ,Risk Factors ,Cause of Death ,Lymphocytes ,030212 general & internal medicine ,Aged, 80 and over ,Hazard ratio ,Middle Aged ,Nutrition Surveys ,Prognosis ,Peripheral ,C-Reactive Protein ,Creatinine ,Cardiology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,National Health and Nutrition Examination Survey ,Urinary system ,030209 endocrinology & metabolism ,Risk Assessment ,Decision Support Techniques ,Peripheral Arterial Disease ,03 medical and health sciences ,Predictive Value of Tests ,Internal medicine ,Linear regression ,medicine ,Albuminuria ,Humans ,Ankle Brachial Index ,Lymphocyte Count ,Aged ,Proportional Hazards Models ,business.industry ,United States ,Cross-Sectional Studies ,chemistry ,Surgery ,business ,Biomarkers - Abstract
Few studies have assessed which biomarkers influence mortality risk among those with peripheral arterial disease (PAD). We analyzed data from 556 individuals identified to have PAD (i.e. ankle–brachial index ⩽0.9) with available measurements of C-reactive protein, the neutrophil-to-lymphocyte ratio (NLR), homocysteine, and the urinary albumin-to-creatinine ratio (UACR) in the 1999–2004 National Health and Nutrition Examination Survey. We investigated whether a combination of these biomarkers improved the prediction of all-cause and cardiovascular mortality beyond conventional risk factors. During follow-up (median, 8.1 years), 277 of 556 participants died; 63 deaths were attributed to cardiovascular disease. After adjusting for conventional risk factors, Cox proportional-hazards models showed the following to be most strongly associated with all-cause mortality (each is followed by the adjusted hazard ratio [HR] per 1 standard deviation increment in the log values): homocysteine (1.31), UACR (1.21), and NLR (1.20). UACR alone significantly predicted cardiovascular mortality (1.53). Persons in the highest quintile of multimarker scores derived from regression coefficients of significant biomarkers had elevated risks of all-cause mortality (adjusted HR, 2.45; 95% CI, 1.66–3.62; p for trend
- Published
- 2016
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