Evidence map›Paper›PMID 32595156›Full record

ArticleBMJ open2020

Biomarkers versus traditional risk factors to predict cardiovascular events in very old adults: cross-validated prospective cohort study.

Bert Vaes, Paulien Indestege, Tinne Serneels, Eralda Hegendörfer, Petra G van Peet, Rosalinde K E Poortvliet, Pierre Wallemacq, Jacobijn Gussekloo, Jan Degryse

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Bert VaesDepartment of Public Health and Primary Care, KU Leuven, Leuven, Belgium bert.vaes@kuleuven.be.ORCID 0000-0001-5244-1930
Paulien IndestegeDepartment of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Tinne SerneelsDepartment of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Eralda HegendörferDepartment of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Petra G van PeetDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Rosalinde K E PoortvlietDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Pierre WallemacqLaboratory of Analytical Biochemistry, Cliniques Universitaires St Luc, Université catholique de Louvain (UCL), Brussels, Belgium.
Jacobijn GusseklooDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Jan DegryseDepartment of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
KU Leuven · BELeiden University Medical Center · NLUCLouvain · BECliniques Universitaires Saint-Luc · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo test new cardiovascular (CV) risk models in very old adults with and without a history of CV disease (CVD), based on traditional risk factors and biomarkers.

designCross-validated prospective cohort study. The models were tested in the BELFRAIL Study and externally validated in the Leiden 85-plus Study.

settingGeneral practice, Belgium and The Netherlands.

participantsThe BELFRAIL cohort consisted of 266 patients aged 80 years or older without a history of CVD and 260 with a history of CVD. The Leiden 85-plus Study consisted of 264 patients aged 85 years without a history of CVD and 282 with a history of CVD. OUTCOME MEASURES: The model with traditional risk factors and biomarkers, as well as the model using only biomarkers, was compared with the model with only traditional risk factors to predict 3-year CV morbidity and mortality. A competing-risk analysis was performed, and the continuous net reclassification improvement (NRI), integrated discrimination improvement (IDI) and net benefit were used to compare the predictive value of the different models.

resultsTraditional risk factors poorly predicted CV mortality and morbidity. In participants without a history of CVD, adding N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) improved the prediction (NRI 0.56 (95% CI 0.16 to 0.99) and relative IDI 4.01 (95% CI 2.19 to 6.28)). In participants with a history of CVD, the NRI with the addition of NT-pro-BNP and high-sensitivity C reactive protein was 0.38 (95% CI 0.09 to 0.70), and the relative IDI was 0.53 (95% CI 0.23 to 0.90). Moreover, in participants without a history of CVD, NT-pro-BNP performed well as a stand-alone predictor (NRI 0.32 (95% CI -0.12 to 0.74) and relative IDI 3.44 (95% CI 1.56 to 6.09)).

conclusionsThis study tested new risk models to predict CV morbidity and mortality in very old adults. Especially, NT-pro-BNP showed a strong added predictive value. This opens perspectives for clinicians who are in need of an easily applicable strategy for CV risk prediction in very old adults.

Indexed as

Heart Disease Risk FactorsAged, 80 and overBelgiumBiomarkersFemaleGeneral PracticeHumansMaleNetherlandsPredictive Value of TestsProspective StudiesRisk AssessmentBiomarkerscardiac epidemiologyepidemiologygeriatric medicine

Identifiers

PMID32595156
PMCPMC7322328
OpenAlexW3037950731

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.