Oxidation-Specific Biomarkers, Prospective 15-Year Cardiovascular and Stroke Outcomes, and Net Reclassification of Cardiovascular Events
Key result
High OxPL/apoB linked to ~140% increased 15-year incident CVD risk vs. lowest tertile.
- HR 2.4
- 95% CI 1.5-3.7
- n=765
Why the study?
Do oxidation-specific biomarkers predict 15-year cardiovascular and stroke outcomes and improve risk reclassification in the general community?
Population
765 men and women aged 45 to 84 years from the general community (Bruneck study)
Comparison
Measurement of oxidation-specific biomarkers vs Lowest tertile of biomarker levels
Design
Cohort
Follow-up
15 years
Authors
Discussion
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Member takes
Implication
Oxidation-specific biomarkers, particularly OxPL/apoB, independently predict 15-year cardiovascular risk and improve risk reclassification beyond traditional risk assessment.
Key Points
- To determine the 15-year predictive value and net reclassification improvement of oxidation-specific epitope biomarkers for cardiovascular disease and stroke risk.
- Evaluated 765 community-dwelling men and women aged 45 to 84 years from the Bruneck study with 15 years of follow-up.
- Measured baseline plasma levels of oxidized phospholipids on apolipoprotein B-100 (OxPL/apoB) and autoantibodies (IgG and IgM) against malondialdehyde-modified and copper-oxidized low-density lipoprotein.
- Over 15 years, 138 participants reached the primary endpoint of incident cardiovascular disease, with the highest OxPL/apoB tertile showing elevated risk for cardiovascular disease (HR: 2.4; 95% CI: 1.5 to 3.7) and stroke (HR: 3.6; 95% CI: 1.8 to 7.4).
- Incorporating OxPL/apoB, IgG Cu-OxLDL, and IgM MDA-LDL increased the prediction area under the curve from 0.664 (95% CI: 0.629 to 0.697) to 0.705 (95% CI: 0.672 to 0.737; p = 0.048).
- The net reclassification index was 0.163 (p = 0.0044) across all 765 subjects and 0.332 (p < 0.0001) among 305 subjects at intermediate baseline risk.
Study Design
Type
Cohort (n=765)
Structured PICO
Do oxidation-specific biomarkers predict 15-year cardiovascular and stroke outcomes and improve risk reclassification in the general community?
P
Population
765 men and women aged 45 to 84 years from the general community, followed for 15 years to assess cardiovascular risk.
E
Exposure
Measurement of oxidation-specific biomarkers (oxidized phospholipids on apolipoprotein B-100 [OxPL/apoB], IgG Cu-OxLDL, and IgM MDA-LDL)
C
Comparator
Lowest tertile of biomarker levels
O
Outcome
Incident CVD (composite of ischemic stroke, myocardial infarction, new-onset unstable angina, acute coronary interventions, and vascular death) over 15 yearscomposite
Main Result
Hazard Ratio: 2.4 (95% CI 1.5–3.7)
Oxidation-specific biomarkers, particularly OxPL/apoB, independently predict 15-year cardiovascular risk and improve risk reclassification beyond traditional risk assessment.
Cite This Study
Tsimikas et al. (2012) conducted a cohort in Risk of cardiovascular disease (n=765). Highest tertile of OxPL/apoB vs. Lowest tertile of OxPL/apoB was evaluated on incident CVD (ischemic stroke, myocardial infarction, new-onset unstable angina, acute coronary interventions, and vascular death) (HR 2.4, 95% CI 1.5-3.7). The highest tertile of OxPL/apoB was associated with a higher 15-year risk of incident cardiovascular disease compared with the lowest tertile (HR 2.4; 95% CI 1.5-3.7).