The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease

C M Gijsberts; I E M Bank; A Seneviratna; H M den Ruijter; F W Asselbergs; P Agostoni; J A Remijn; G Pasterkamp; H C Kiat; M Roest; A M Richards; M Y Chan; D P V de Kleijn; I E Hoefer

doi:10.1007/s12471-015-0798-y

The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease

C M Gijsberts, I E M Bank, A Seneviratna, H M den Ruijter, F W Asselbergs, P Agostoni, J A Remijn, G Pasterkamp, H C Kiat, M Roest, A M Richards, M Y Chan, D P V de Kleijn, I E Hoefer

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Abstract

BACKGROUND: Risk factor burden and clinical characteristics of patients with coronary artery disease (CAD) differ among ethnic groups. We related biomarkers to CAD severity in Caucasians, Chinese, Indians and Malays.

METHODS: In the Dutch-Singaporean UNICORN coronary angiography cohort (n = 2033) we compared levels of five cardiovascular biomarkers: N-terminal pro-brain natriuretic peptide (NTproBNP), high-sensitivity C-reactive protein (hsCRP), cystatin C (CysC), myeloperoxidase (MPO) and high-sensitivity troponin I (hsTnI). We assessed ethnicity-specific associations of biomarkers with CAD severity, quantified by the SYNTAX score.

RESULTS: Adjusted for baseline differences, NTproBNP levels were significantly higher in Malays than in Chinese and Caucasians (72.1 vs. 34.4 and 41.1 pmol/l, p < 0.001 and p = 0.005, respectively). MPO levels were higher in Caucasians than in Indians (32.8 vs. 27.2 ng/ml, p = 0.026), hsTnI levels were higher in Malays than in Caucasians and Indians (33.3 vs. 16.4 and 17.8 ng/l, p < 0.001 and p = 0.029) and hsTnI levels were higher in Chinese than in Caucasians (23.3 vs. 16.4, p = 0.031). We found modifying effects of ethnicity on the association of biomarkers with SYNTAX score. NTproBNP associated more strongly with the SYNTAX score in Malays than Caucasians (β 0.132 vs. β 0.020 per 100 pmol/l increase in NTproBNP, p = 0.032). For MPO levels the association was stronger in Malays than Caucasians (β 1.146 vs. β 0.016 per 10 ng/ml increase, p = 0.017). Differing biomarker cut-off levels were found for the ethnic groups.

CONCLUSION: When corrected for possible confounders we observe ethnicity-specific differences in biomarker levels. Moreover, biomarkers associated differently with CAD severity, suggesting that ethnicity-specific cut-off values should be considered.

Original language	English
Pages (from-to)	188-198
Journal	Netherlands Heart Journal
Volume	24
Issue number	3
DOIs	https://doi.org/10.1007/s12471-015-0798-y
Publication status	Published - Mar 2016

Keywords

Ethnicity
Coronary angiography
Biomarkers
Singapore

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Gijsberts, C. M., Bank, I. E. M., Seneviratna, A., den Ruijter, H. M., Asselbergs, F. W., Agostoni, P., Remijn, J. A., Pasterkamp, G., Kiat, H. C., Roest, M., Richards, A. M., Chan, M. Y., de Kleijn, D. P. V., & Hoefer, I. E. (2016). The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease. Netherlands Heart Journal, 24(3), 188-198. https://doi.org/10.1007/s12471-015-0798-y

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title = "The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease",

abstract = "BACKGROUND: Risk factor burden and clinical characteristics of patients with coronary artery disease (CAD) differ among ethnic groups. We related biomarkers to CAD severity in Caucasians, Chinese, Indians and Malays.METHODS: In the Dutch-Singaporean UNICORN coronary angiography cohort (n = 2033) we compared levels of five cardiovascular biomarkers: N-terminal pro-brain natriuretic peptide (NTproBNP), high-sensitivity C-reactive protein (hsCRP), cystatin C (CysC), myeloperoxidase (MPO) and high-sensitivity troponin I (hsTnI). We assessed ethnicity-specific associations of biomarkers with CAD severity, quantified by the SYNTAX score.RESULTS: Adjusted for baseline differences, NTproBNP levels were significantly higher in Malays than in Chinese and Caucasians (72.1 vs. 34.4 and 41.1 pmol/l, p < 0.001 and p = 0.005, respectively). MPO levels were higher in Caucasians than in Indians (32.8 vs. 27.2 ng/ml, p = 0.026), hsTnI levels were higher in Malays than in Caucasians and Indians (33.3 vs. 16.4 and 17.8 ng/l, p < 0.001 and p = 0.029) and hsTnI levels were higher in Chinese than in Caucasians (23.3 vs. 16.4, p = 0.031). We found modifying effects of ethnicity on the association of biomarkers with SYNTAX score. NTproBNP associated more strongly with the SYNTAX score in Malays than Caucasians (β 0.132 vs. β 0.020 per 100 pmol/l increase in NTproBNP, p = 0.032). For MPO levels the association was stronger in Malays than Caucasians (β 1.146 vs. β 0.016 per 10 ng/ml increase, p = 0.017). Differing biomarker cut-off levels were found for the ethnic groups.CONCLUSION: When corrected for possible confounders we observe ethnicity-specific differences in biomarker levels. Moreover, biomarkers associated differently with CAD severity, suggesting that ethnicity-specific cut-off values should be considered.",

keywords = "Ethnicity, Coronary angiography, Biomarkers, Singapore",

author = "Gijsberts, {C M} and Bank, {I E M} and A Seneviratna and {den Ruijter}, {H M} and Asselbergs, {F W} and P Agostoni and Remijn, {J A} and G Pasterkamp and Kiat, {H C} and M Roest and Richards, {A M} and Chan, {M Y} and {de Kleijn}, {D P V} and Hoefer, {I E}",

year = "2016",

month = mar,

doi = "10.1007/s12471-015-0798-y",

language = "English",

volume = "24",

pages = "188--198",

journal = "Netherlands Heart Journal",

issn = "1568-5888",

publisher = "Bohn Stafleu van Loghum",

number = "3",

}

Gijsberts, CM, Bank, IEM, Seneviratna, A, den Ruijter, HM , Asselbergs, FW, Agostoni, P, Remijn, JA, Pasterkamp, G, Kiat, HC, Roest, M, Richards, AM, Chan, MY, de Kleijn, DPV & Hoefer, IE 2016, 'The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease', Netherlands Heart Journal, vol. 24, no. 3, pp. 188-198. https://doi.org/10.1007/s12471-015-0798-y

TY - JOUR

T1 - The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease

AU - Gijsberts, C M

AU - Bank, I E M

AU - Seneviratna, A

AU - den Ruijter, H M

AU - Asselbergs, F W

AU - Agostoni, P

AU - Remijn, J A

AU - Pasterkamp, G

AU - Kiat, H C

AU - Roest, M

AU - Richards, A M

AU - Chan, M Y

AU - de Kleijn, D P V

AU - Hoefer, I E

PY - 2016/3

Y1 - 2016/3

N2 - BACKGROUND: Risk factor burden and clinical characteristics of patients with coronary artery disease (CAD) differ among ethnic groups. We related biomarkers to CAD severity in Caucasians, Chinese, Indians and Malays.METHODS: In the Dutch-Singaporean UNICORN coronary angiography cohort (n = 2033) we compared levels of five cardiovascular biomarkers: N-terminal pro-brain natriuretic peptide (NTproBNP), high-sensitivity C-reactive protein (hsCRP), cystatin C (CysC), myeloperoxidase (MPO) and high-sensitivity troponin I (hsTnI). We assessed ethnicity-specific associations of biomarkers with CAD severity, quantified by the SYNTAX score.RESULTS: Adjusted for baseline differences, NTproBNP levels were significantly higher in Malays than in Chinese and Caucasians (72.1 vs. 34.4 and 41.1 pmol/l, p < 0.001 and p = 0.005, respectively). MPO levels were higher in Caucasians than in Indians (32.8 vs. 27.2 ng/ml, p = 0.026), hsTnI levels were higher in Malays than in Caucasians and Indians (33.3 vs. 16.4 and 17.8 ng/l, p < 0.001 and p = 0.029) and hsTnI levels were higher in Chinese than in Caucasians (23.3 vs. 16.4, p = 0.031). We found modifying effects of ethnicity on the association of biomarkers with SYNTAX score. NTproBNP associated more strongly with the SYNTAX score in Malays than Caucasians (β 0.132 vs. β 0.020 per 100 pmol/l increase in NTproBNP, p = 0.032). For MPO levels the association was stronger in Malays than Caucasians (β 1.146 vs. β 0.016 per 10 ng/ml increase, p = 0.017). Differing biomarker cut-off levels were found for the ethnic groups.CONCLUSION: When corrected for possible confounders we observe ethnicity-specific differences in biomarker levels. Moreover, biomarkers associated differently with CAD severity, suggesting that ethnicity-specific cut-off values should be considered.

AB - BACKGROUND: Risk factor burden and clinical characteristics of patients with coronary artery disease (CAD) differ among ethnic groups. We related biomarkers to CAD severity in Caucasians, Chinese, Indians and Malays.METHODS: In the Dutch-Singaporean UNICORN coronary angiography cohort (n = 2033) we compared levels of five cardiovascular biomarkers: N-terminal pro-brain natriuretic peptide (NTproBNP), high-sensitivity C-reactive protein (hsCRP), cystatin C (CysC), myeloperoxidase (MPO) and high-sensitivity troponin I (hsTnI). We assessed ethnicity-specific associations of biomarkers with CAD severity, quantified by the SYNTAX score.RESULTS: Adjusted for baseline differences, NTproBNP levels were significantly higher in Malays than in Chinese and Caucasians (72.1 vs. 34.4 and 41.1 pmol/l, p < 0.001 and p = 0.005, respectively). MPO levels were higher in Caucasians than in Indians (32.8 vs. 27.2 ng/ml, p = 0.026), hsTnI levels were higher in Malays than in Caucasians and Indians (33.3 vs. 16.4 and 17.8 ng/l, p < 0.001 and p = 0.029) and hsTnI levels were higher in Chinese than in Caucasians (23.3 vs. 16.4, p = 0.031). We found modifying effects of ethnicity on the association of biomarkers with SYNTAX score. NTproBNP associated more strongly with the SYNTAX score in Malays than Caucasians (β 0.132 vs. β 0.020 per 100 pmol/l increase in NTproBNP, p = 0.032). For MPO levels the association was stronger in Malays than Caucasians (β 1.146 vs. β 0.016 per 10 ng/ml increase, p = 0.017). Differing biomarker cut-off levels were found for the ethnic groups.CONCLUSION: When corrected for possible confounders we observe ethnicity-specific differences in biomarker levels. Moreover, biomarkers associated differently with CAD severity, suggesting that ethnicity-specific cut-off values should be considered.

KW - Ethnicity

KW - Coronary angiography

KW - Biomarkers

KW - Singapore

U2 - 10.1007/s12471-015-0798-y

DO - 10.1007/s12471-015-0798-y

M3 - Article

C2 - 26754611

SN - 1568-5888

VL - 24

SP - 188

EP - 198

JO - Netherlands Heart Journal

JF - Netherlands Heart Journal

IS - 3

ER -

The ethnicity-specific association of biomarkers with the angiographic severity of coronary artery disease

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