C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults

Detalhes bibliográficos
Autor(a) principal: Beleigoli, Alline Maria
Data de Publicação: 2013
Outros Autores: Boersma, Eric, Diniz, Maria de Fatima Haueisen, Vidigal, Pedro G., Costa, Maria Fernanda Furtado Lima, Ribeiro, Antonio Luiz Pinho
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/59391
Resumo: This work was supported by Financiadora de Estudos e Projetos, Rio de Janeiro, Brazil; Ministério da Saúde, Brasília, Brazil; Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Belo Horizonte, Brazil. M.F. Lima-Costa and A.L. Ribeiro are fellows of Conselho Nacional de Desenvolvimento Científico e Tecnológico. A.M. Beleigoli was supported by the Programa de Doutorando com Estágio no Exterior do Conselho de Aperfeiçoamento de Pessoal Superior, Brazil. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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spelling Beleigoli, Alline MariaBoersma, EricDiniz, Maria de Fatima HaueisenVidigal, Pedro G.Costa, Maria Fernanda Furtado LimaRibeiro, Antonio Luiz Pinho2023-07-04T12:45:30Z2023-07-04T12:45:30Z2013BELEIGOLI, Alline Maria et al. C-reactive protein and B-type natriuretic peptide yield either a non-significant or a modest incremental value to traditional risk factors in predicting long-term overall mortality in older adults. PLoS One, v. 8, n. 9, p. 1-10, e75809, 2013.1932-6203https://www.arca.fiocruz.br/handle/icict/5939110.1371/journal.pone.0075809This work was supported by Financiadora de Estudos e Projetos, Rio de Janeiro, Brazil; Ministério da Saúde, Brasília, Brazil; Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Belo Horizonte, Brazil. M.F. Lima-Costa and A.L. Ribeiro are fellows of Conselho Nacional de Desenvolvimento Científico e Tecnológico. A.M. Beleigoli was supported by the Programa de Doutorando com Estágio no Exterior do Conselho de Aperfeiçoamento de Pessoal Superior, Brazil. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Universidade Federal de Minas Gerais. Faculty of Medicine. Department of Internal Medicine. Belo Horizonte, MG, Brazil / Universidade Federal de Minas Gerais. Faculty of Medicine. Post-Graduation Department. Belo Horizonte, MG, Brazil.Department of Cardiology. Erasmus Medical Center. Rotterdam, The Netherlands.Universidade Federal de Minas Gerais. Faculty of Medicine. Department of Internal Medicine. Belo Horizonte, MG, Brazil / Universidade Federal de Minas Gerais. Faculty of Medicine. Post-Graduation Department. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculty of Medicine. Department of Diagnostic Medicine. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculty of Medicine. Department of Internal Medicine. Belo Horizonte, MG, Brazil / Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculty of Medicine. Department of Internal Medicine. Belo Horizonte, MG, Brazil / Universidade Federal de Minas Gerais. Faculty of Medicine. Post-Graduation Department. Belo Horizonte, MG, Brazil / Universidade Federal de Minas Gerais. Faculty of Medicine. Hospital das Clínicas. Belo Horizonte, MG, Brazil.Background: New biomarkers may aid in preventive and end-of-life decisions in older adults if they enhance the prognostic ability of traditional risk factors. We investigated whether C-reactive protein (CRP) and/or B-type natriuretic peptide (BNP) improve the ability to predict overall mortality among the elderly of the Bambu, Brazil Study of Aging when added to traditional risk factors. Methods: From 1997 to 2007, 1,470 community-dwelling individuals (>= 60 years) were followed-up. Death was ascertained by continuous verification of death certificates. We calculated hazard ratios per 1 standard deviation change (HR) of death for traditional risk factors only (old model), and traditional risk factors plus CRP and/or BNP (new models) and assessed calibration of the models. Subsequently, we compared c-statistic of each of the new models to the old one, and calculated integrated discriminative improvement (IDI) and net reclassification improvement (NRI). Results: 544 (37.0%) participants died in a mean follow-up time of 9.0 years. CRP (HR 1.28, 95% CI 1.17-1.40), BNP (HR 1.31 95% CI 1.19-1.45), and CRP plus BNP (HR 1.26, 95% CI 1.15-1.38, and HR 1.29, 95% CI 1.16-1.42, respectively) were independent determinants of mortality. All models were well-calibrated. Discrimination was similar among the old (c-statistic 0.78 [0.78-0.81]) and new models (p=0.43 for CRP; p=0.57 for BNP; and p=0.31 for CRP plus BNP). Compared to the old model, CRP, BNP, and CRP plus BNP models led to an IDI of 0.009 (p<0.001), -0.005 (p<0.001) and -0.003 (p=0.84), and a NRI of 0.04 (p=0.24), 0.07 (p=0.08) and 0.06 (p=0.10), respectively. Conclusions: Despite being independent predictors of long-term risk of death, compared to traditional risk factors CRP and/or BNP led to either a modest or non-significant improvement in the ability of predicting all-cause mortality in older adults.engPublic Library of ScienceC-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adultsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleC-Reactive Protein (CRP)B-type natriuretic peptide (BNP)BiomarkersTraditional risk factorsMortality in older Adultsinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALpone.0075809.pdfpone.0075809.pdfapplication/pdf1049554https://www.arca.fiocruz.br/bitstream/icict/59391/2/pone.0075809.pdf95a23081d30cc56f0740b34f3cf13867MD52LICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/59391/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51icict/593912023-07-04 12:05:55.24oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-07-04T15:05:55Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.en_US.fl_str_mv C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
title C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
spellingShingle C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
Beleigoli, Alline Maria
C-Reactive Protein (CRP)
B-type natriuretic peptide (BNP)
Biomarkers
Traditional risk factors
Mortality in older Adults
title_short C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
title_full C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
title_fullStr C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
title_full_unstemmed C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
title_sort C-Reactive Protein and B-Type Natriuretic Peptide Yield Either a Non-Significant or a Modest Incremental Value to Traditional Risk Factors in Predicting Long-Term Overall Mortality in Older Adults
author Beleigoli, Alline Maria
author_facet Beleigoli, Alline Maria
Boersma, Eric
Diniz, Maria de Fatima Haueisen
Vidigal, Pedro G.
Costa, Maria Fernanda Furtado Lima
Ribeiro, Antonio Luiz Pinho
author_role author
author2 Boersma, Eric
Diniz, Maria de Fatima Haueisen
Vidigal, Pedro G.
Costa, Maria Fernanda Furtado Lima
Ribeiro, Antonio Luiz Pinho
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Beleigoli, Alline Maria
Boersma, Eric
Diniz, Maria de Fatima Haueisen
Vidigal, Pedro G.
Costa, Maria Fernanda Furtado Lima
Ribeiro, Antonio Luiz Pinho
dc.subject.en.none.fl_str_mv C-Reactive Protein (CRP)
B-type natriuretic peptide (BNP)
Biomarkers
Traditional risk factors
Mortality in older Adults
topic C-Reactive Protein (CRP)
B-type natriuretic peptide (BNP)
Biomarkers
Traditional risk factors
Mortality in older Adults
description This work was supported by Financiadora de Estudos e Projetos, Rio de Janeiro, Brazil; Ministério da Saúde, Brasília, Brazil; Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Belo Horizonte, Brazil. M.F. Lima-Costa and A.L. Ribeiro are fellows of Conselho Nacional de Desenvolvimento Científico e Tecnológico. A.M. Beleigoli was supported by the Programa de Doutorando com Estágio no Exterior do Conselho de Aperfeiçoamento de Pessoal Superior, Brazil. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
publishDate 2013
dc.date.issued.fl_str_mv 2013
dc.date.accessioned.fl_str_mv 2023-07-04T12:45:30Z
dc.date.available.fl_str_mv 2023-07-04T12:45:30Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.citation.fl_str_mv BELEIGOLI, Alline Maria et al. C-reactive protein and B-type natriuretic peptide yield either a non-significant or a modest incremental value to traditional risk factors in predicting long-term overall mortality in older adults. PLoS One, v. 8, n. 9, p. 1-10, e75809, 2013.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/59391
dc.identifier.issn.en_US.fl_str_mv 1932-6203
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pone.0075809
identifier_str_mv BELEIGOLI, Alline Maria et al. C-reactive protein and B-type natriuretic peptide yield either a non-significant or a modest incremental value to traditional risk factors in predicting long-term overall mortality in older adults. PLoS One, v. 8, n. 9, p. 1-10, e75809, 2013.
1932-6203
10.1371/journal.pone.0075809
url https://www.arca.fiocruz.br/handle/icict/59391
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
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instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/59391/2/pone.0075809.pdf
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