1. Protein Biomarkers and Cardiovascular Outcomes in People With Type 2 Diabetes and Acute Coronary Syndrome: The ELIXA Biomarker Study.
- Author
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Gerstein, Hertzel C., Hess, Sibylle, Claggett, Brian, Dickstein, Kenneth, Kober, Lars, Maggioni, Aldo P., McMurray, John J.V., Probstfield, Jeffrey L., Riddle, Matthew C., Tardif, Jean-Claude, and Pfeffer, Marc A.
- Subjects
RESEARCH ,RESEARCH methodology ,ACUTE coronary syndrome ,PROGNOSIS ,EVALUATION research ,TYPE 2 diabetes ,RISK assessment ,COMPARATIVE studies ,RESEARCH funding ,PEPTIDE hormones ,PEPTIDES ,DISEASE complications - Abstract
Objective: To use protein biomarkers to identify people with type 2 diabetes at high risk of cardiovascular outcomes and death.Research Design and Methods: Biobanked serum from 4,957 ELIXA (Evaluation of Lixisenatide in Acute Coronary Syndrome) trial participants was analyzed. Forward-selection Cox models identified independent protein risk factors for major adverse cardiovascular events (MACE) and death that were compared with a previously validated biomarker panel.Results: NT-proBNP and osteoprotegerin predicted both outcomes. In addition, trefoil factor 3 predicted MACE, and angiopoietin-2 predicted death (C = 0.70 and 0.79, respectively, compared with 0.63 and 0.66 for clinical variables alone). These proteins had all previously been identified and validated. Notably, C statistics for just NT-proBNP plus clinical risk factors were 0.69 and 0.78 for MACE and death, respectively.Conclusions: NT-proBNP and other proteins independently predict cardiovascular outcomes in people with type 2 diabetes following acute coronary syndrome. Adding other biomarkers only marginally increased NT-proBNP's prognostic value. [ABSTRACT FROM AUTHOR]- Published
- 2022
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