Introduction
Methods
Patient population
Risk markers
Coronary angiography
Outcomes
Statistics
Results
Baseline characteristics and associations
Characteristic | All N = 522 | BNP ≤ 100 pg/mL N = 407 | BNP > 100 pg/mL N = 115 | p value |
---|---|---|---|---|
Median (IQR) or % | Median (IQR) or % | Median (IQR) or % | ||
Age, years | 66 (58–73) | 64 (56–71) | 70 (65–76) | < 0.0001 |
Women, % | 32.8% | 33.4% | 30.4% | NS |
Current smoker, % | 16.1% | 17.2% | 12.2% | NS |
Prior myocardial infarction, % | 22.2% | 20.9% | 27.0% | NS |
Prior revascularization, % | 20.9% | 19.9% | 24.3% | NS |
Diabetes mellitus, % | 22.0% | 23.3% | 17.4% | NS |
Left ventricular ejection fraction, %* | 64 (53–71) | 65 (58–72) | 53 (39–67) | < 0.0001 |
Left ventricular systolic dysfunction, % | 19.0% | 13.0% | 40.0% | < 0.0001 |
Body mass index, kg/m2 | 28 (25–31) | 28 (26–31) | 27 (25–31) | NS |
Systolic blood pressure, mmHg | 140 (129–156) | 139 (129–153) | 145 (131–161) | 0.019 |
Diastolic blood pressure, mmHg | 79 (72–86) | 79 (73–86) | 77 (69–85) | NS |
Central augmentation pressure, mmHg† | 16 (9–23) | 15 (9–22) | 20 (10–27) | 0.003 |
≥ 24 mmHg | 23.5% | 18.7% | 40.7% | 0.0002 |
Central pulse pressure, mmHg† | 50 (39–63) | 49 (39–61) | 56 (42–73) | 0.001 |
≥ 50 mmHg | 52.1% | 49.1% | 62.8% | 0.13 |
Total cholesterol, mmol/L | 4.5 (3.8–5.2) | 4.5 (3.9–5.4) | 4.1 (3.5–4.7) | < 0.0001 |
High-density lipoprotein cholesterol, mmol/L | 1.2 (1.0–1.4) | 1.2 (1.0–1.4) | 1.2 (1.0–1.5) | NS |
Estimated glomerular filtration rate, mL/min | 82 (68–97) | 85 (69–98) | 78 (60–93) | 0.002 |
Low-frequency heart rate variability, ms2 ‡ | 211 (72–470) | 213 (85–446) | 191 (27–1017) | NS |
> 250 ms2 | 56.5% | 57.4% | 52.7% | NS |
Total power heart rate variability, ms2 ‡ | 830 (323–1954) | 766 (360–1764) | 1101 (198–3150) | NS |
High-sensitivity C-reactive protein, mg/L⁋ | 1.9 (0.9–4.0) | 1.9 (0.8–3.9) | 2.1 (1.0–4.5) | NS |
> 3 mg/L | 32.4% | 31.9% | 34.2% | NS |
B-type natriuretic peptide, pg/mL | 40 (15–90) | 27 (12–53) | 188 (137–413) | – |
> 100 pg/mL | 22.0% | |||
> 400 pg/mL | 5.6% | |||
Framingham 10-year risk, % | 11 (8–20) | 11 (7–20) | 13 (8–20) | NS |
SCORE 10-year risk, % | 9 (4–17) | 8 (3–16) | 12 (7–22) | < 0.0001 |
Coronary disease, revascularization and risk reduction
Adjudicated outcomes
All-cause mortality | Death, MI or stroke | |||||
---|---|---|---|---|---|---|
HR | 95% CI | p value | HR | 95% CI | p value | |
Main multivariate model* | ||||||
Age (per 10 years) | 2.29 | 1.51–3.48 | < 0.001 | 1.63 | 1.24–2.13 | < 0.001 |
Male gender | 1.82 | 0.86–3.82 | 0.12 | 1.91 | 1.10–3.33 | 0.022 |
Prior myocardial infarction | 1.71 | 0.85–3.44 | 0.13 | 1.60 | 0.98–2.61 | 0.06 |
Diabetes | 1.13 | 0.55–2.32 | 0.74 | 1.34 | 0.82–2.18 | 0.24 |
Smoking | 1.39 | 0.63–3.10 | 0.41 | 1.39 | 0.78–2.47 | 0.26 |
Presence of impaired left ventricular function | 1.32 | 0.63–2.77 | 0.46 | 1.22 | 0.72–2.08 | 0.46 |
Extent of angiographic CAD (per vessel with ≥ 50%) | 1.03 | 0.77–1.39 | 0.84 | 0.90 | 0.72–1.13 | 0.38 |
Revascularization | 0.45 | 0.23–0.87 | 0.018 | 1.18 | 0.73–1.91 | 0.49 |
Cholesterol (per 1 mmol/L) | 1.09 | 0.79–1.49 | 0.60 | 1.14 | 0.91–1.42 | 0.26 |
Systolic blood pressure (per 1 mmHg) | 0.99 | 0.98–1.01 | 0.36 | 0.99 | 0.98–1.01 | 0.36 |
BNP (per log unit) | 2.15 | 1.45–3.19 | < 0.001 | 1.27 | 1.04–1.54 | 0.018 |
Additional risk markers† | ||||||
Pulse wave analysis | ||||||
Central augmentation pressure (per 1 mmHg) | 0.97 | 0.93–1.02 | 0.27 | 1.00 | 0.97–1.04 | 0.92 |
Central augmentation index (per 1%) | 0.98 | 0.95–1.01 | 0.26 | 1.00 | 0.98–1.02 | 0.89 |
Central pulse pressure (per 1 mmHg) | 0.98 | 0.93–1.04 | 0.59 | 1.00 | 0.96–1.04 | 0.88 |
Heart rate variability | ||||||
Standard deviation of RR intervals (per log ms) | 0.88 | 0.57–1.37 | 0.58 | 0.91 | 0.67–1.26 | 0.58 |
Low-frequency power (per log ms2) | 0.97 | 0.81–1.15 | 0.70 | 0.97 | 0.85–1.10 | 0.59 |
Total frequency power (per log ms2) | 0.95 | 0.78–1.15 | 0.58 | 0.95 | 0.82–1.09 | 0.45 |
Low to high-frequency power ratio (per log unit) | 1.00 | 0.73–1.38 | 0.99 | 0.96 | 0.78–1.18 | 0.72 |
Other biomarkers | ||||||
High-sensitivity C-reactive protein (per 1 mg/L) | 1.11 | 0.85–1.46 | 0.43 | 1.00 | 0.84–1.20 | 0.98 |
Estimated glomerular filtration rate (per 10 mL/min) | 0.94 | 0.81–1.09 | 0.40 | 0.99 | 0.90–1.08 | 0.76 |
Conventional risk scores‡ | ||||||
Framingham 10-year risk (per log unit) ⁋ | 1.69 | 1.19–2.41 | 0.004 | 1.64 | 1.00–2.68 | 0.049 |
SCORE 10-year risk (per log unit)⁑ | 1.41 | 1.14–1.74 | 0.002 | 1.59 | 1.16–2.17 | 0.004 |