Table 3.
Association Between Major Cardiovascular Events and the Biomarkers Individually and as the BRS
| HR (95% CI); P Value | |||||
|---|---|---|---|---|---|
| All-Cause Death | Cardiovascular Death* | All-Cause Death and MI | All-Cause Death, MI, Revascularization | All-Cause Death, MI, Stroke | |
| All biomarkers in same model | |||||
| CRP ≥3.0 mg/L | 1.69 (1.26-2.27), P<0.001 |
1.57 (0.39-6.38), P=0.53 |
1.58 (1.24-2.02), P<0.001 |
1.31 (1.09-1.56), P=0.003 |
1.58 (1.25-2.00), P<0.001 |
| HSP-70 >0.313 ng/mL | 1.98 (1.46-2.67), P<0.001 |
1.79 (1.17-2.73), P=0.01 |
2.22 (1.71-2.87), P<0.001 |
1.94 (1.60-2.35), P<0.001 |
1.99 (1.56-2.55), P<0.001 |
| FDP ≥1.0 μg/mL | 1.87 (1.42-2.46), P<0.001 |
1.79 (1.25-2.58), P=0.002 |
1.57 (1.23-1.99), P<0.001 |
1.41 (1.16-1.70), P<0.001 |
1.60 (1.27-2.01), P<0.001 |
| suPAR ≥3.5 ng/mL | 2.31 (1.71-3.13), P<0.001 |
2.12 (1.37-3.26), P<0.001 |
1.83 (1.43-2.35), P<0.001 |
1.29 (1.07-1.55), P=0.006 |
1.78 (1.40-2.25), P<0.001 |
| Categorical | |||||
| 1 vs 0 markers | 1.68 (0.96-2.93), P=0.065 |
1.59 (0.79-3.19), P=0.20 |
1.81 (1.19-2.76), P=0.005 |
1.63 (1.25-2.11), P<0.001 |
1.74 (1.18-2.59), P=0.005 |
| 2 vs 0 markers* | 3.40 (2.0-5.76), P<0.001 |
2.52 (1.27-5.01), P=0.01 |
2.59 (1.70-3.94), P<0.001 |
1.93 (1.47-2.54), P<0.001 |
2.49 (1.68-3.69), P<0.001 |
| 3 vs 0 markers* | 7.59 (4.46-12.91), P<0.001 |
5.60 (2.72-11.56), P<0.001 |
6.17 (4.05-9.40), P<0.001 |
3.68 (2.75-4.91), P<0.001 |
5.60 (3.76-8.34), P<0.001 |
| 4 vs 0 markers* | 11.87 (6.5-21.65), P<0.001 |
6.76 (2.81-16.26), P<0.001 |
8.8 (5.32-14.57), P<0.001 |
4.17 (2.82-6.17), P<0.001 |
7.99 (4.93-12.93), P<0.001 |
Analyses were adjusted for age, sex, race, body mass index, glomerular filtration rate, acute myocardial infarction, history of previous myocardial infarction, hypertension, dyslipidemia, diabetes mellitus, left ventricular ejection fraction, history of coronary bypass graft surgery, history of coronary angioplasty, active smoking, Gensini angiographic severity score, aspirin use, statin use, and clopidogrel use. BRS indicates biomarker risk score; CI, confidence interval; CRP, C-reactive protein; FDP, fibrin degradation products; HR, hazard ratio; HSP, heat shock protein; MI, myocardial infarction; and suPAR, soluble urokinase plasminogen activator receptor.
Fine and Gray’s subdistribution hazard model was used to analyze cardiovascular death outcome, considering noncardiovascular death as the competing risk event. Patients with 0 elevated marker was treated as the reference category for the analysis of cardiovascular death.