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Dirk De Bacquer

Publications and source records attributed to Dirk De Bacquer.

At least 19 recordsLinked to original sources
PubMed2007

The impact of psychosocial factors on low back pain: longitudinal results from the Belstress study.

STUDY DESIGN: An epidemiological cohort study. OBJECTIVE: To describe the impact of psychosocial factors, both work and nonwork-related, on the prevalence of low back pain (LBP) after 6.6 years on average. SUMMARY OF BACKGROUND DATA: There is growing consensus that psychosocial factors play a role in the development of LBP, although results are not consistent across studies. METHODS: Within a sample of 2556 middle-aged men and women from the Belstress study, baseline psychosocial factors were measured through self-administered questionnaires and related to prevalent cases of LBP after a mean time interval of 6.6 years through Cox regression analysis. RESULTS: After adjustment for individual and physical risks, including occasional back pain at baseline, the prevalence rate of LBP in men is significantly related to baseline low decision latitude and low social support at work, and nonsignificantly to high job strain, low wage and job satisfaction, feeling stressed at work, and feeling depressed. High job insecurity, feeling stressed at work, and feeling depressed nonsignificantly increase the relative risks for LBP in women. CONCLUSIONS: Based on the results of this study, psychosocial factors (both work and nonwork-related) constitute nonnegligible risks for the development of LBP.

Adult↗
PubMed2007

The glomerular filtration rate in an apparently healthy population and its relation with cardiovascular mortality during 10 years.

AIMS: Moderate-to-severe chronic renal failure is an established risk factor for cardiovascular disease and mortality. However, most studies have been performed in selected populations and the impact of very small decrements of renal function on long-term cardiac morbidity and mortality has not yet been established. Also, the cut-off level of glomerular filtration rate (GFR) from which cardiovascular risk increases has not exactly been established. This study wants to address these questions. METHODS AND RESULTS: Ten year follow-up of a representative population-based cohort comprised 8913 randomly selected, apparently healthy participants. Participants were randomly drawn from Belgian voting lists. Cardiovascular risk factors were noted. Serum creatinine values were corrected to isotope dilution mass spectrometry standard, and GFR was calculated using the recently modified 'modification of diet in renal disease' equation. Participants were followed for 10 years, and cause-specific death was registered by analysis of death certificates. The probability to die from all causes or from cardiovascular causes during the 10 year follow-up period increased in each quartile of GFR, even after correction for different other comorbid conditions. CONCLUSION: Even mild renal failure is an independent risk factor for cardiovascular mortality within 10 years in an apparently healthy unselected population. This detrimental effect starts already at a relatively high GFR of 90 mL/min/1.73 m2 and remains present after correction for other established cardiovascular risk factors.

Cardiovascular Diseases↗
PubMed2006

Smoking trends among adolescents from 1990 to 2002 in ten European countries and Canada.

BACKGROUND: Daily smoking adolescents are a public health problem as they are more likely to become adult smokers and to develop smoking-related health problems later on in their lives. METHODS: The study is part of the four-yearly, cross-national Health Behaviour in School-aged Children study, a school-based survey on a nationally representative sample using a standardised methodology. Data of 4 survey periods are available (1990-2002). Gender-specific daily smoking trends among 14-15 year olds are examined using logistic regressions. Sex ratios are calculated for each survey period and country. Interaction effects between period and gender are examined. RESULTS: Daily smoking prevalence in boys in 2002 ranges from 5.5% in Sweden to 20.0% in Latvia. Among girls, the daily smoking prevalence in 2002 ranges from 8.9% in Poland to 24.7% in Austria. Three daily smoking trend groups are identified: countries with a declining or stagnating trend, countries with an increasing trend followed by a decreasing trend, and countries with an increasing trend. These trend groups show a geographical pattern, but are not linked to smoking prevalence. Over the 4 surveys, the sex ratio has changed in Belgium, Switzerland, and Latvia. CONCLUSION: Among adolescents in Europe, three groups of countries in a different stage of the smoking epidemic curve can be identified, with girls being in an earlier stage than boys. In 2002, large differences in smoking prevalence between the countries have been observed. This predicts a high mortality due to smoking over 20-30 years for some countries, if no policy interventions are taken.

Adolescent↗
PubMed2006

Risk factors for primary ventricular fibrillation during acute myocardial infarction: a systematic review and meta-analysis.

AIMS: To evaluate potential risk factors for primary ventricular fibrillation (PVF) during acute myocardial infarction (AMI) by a systematic review and meta-analyses. METHODS AND RESULTS: We searched PubMed for English articles on 'humans' published between 1964 and January 2006 using a validated combination of MESH terms. Twenty-one cohort studies describing 57 158 patients with AMI were analysed. Patients with validated PVF (n=2316) were characterized by an earlier admission (weighted mean difference -2.62 h), male gender [odds ratio (OR 1.27)], smoking (OR 1.26), absence of history of angina (OR for history of angina 0.84), lower heart rate at admission (weighted mean difference -4.02 b.p.m.), ST-segment elevation on admission ECG (OR 3.35), AV conduction block before PVF (OR 2.02), and lower serum potassium at admission (weighted mean difference -0.27 meq/L). Patients with validated PVF developed a larger enzymatic infarct size (standardized mean difference 0.74, P<0.00001). PVF was not associated with a history of myocardial infarction or hypertension. CONCLUSION: Patients who developed a validated PVF presented with characteristics of both abrupt coronary occlusion and early hospital admission. This review provides no evidence for risk factors for PVF other than ST-elevation and time from onset of symptoms. To find new risk factors, studies should compare validated PVF patients with non-PVF patients who have no signs of heart failure and comparable time delay between onset of symptoms and medical attendance.

Case-Control Studies↗
PubMed2006

RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis.

INTRODUCTION: The lack of a standard definition for acute kidney injury has resulted in a large variation in the reported incidence and associated mortality. RIFLE, a newly developed international consensus classification for acute kidney injury, defines three grades of severity--risk (class R), injury (class I) and failure (class F)--but has not yet been evaluated in a clinical series. METHODS: We performed a retrospective cohort study, in seven intensive care units in a single tertiary care academic center, on 5,383 patients admitted during a one year period (1 July 2000-30 June 2001). RESULTS: Acute kidney injury occurred in 67% of intensive care unit admissions, with maximum RIFLE class R, class I and class F in 12%, 27% and 28%, respectively. Of the 1,510 patients (28%) that reached a level of risk, 840 (56%) progressed. Patients with maximum RIFLE class R, class I and class F had hospital mortality rates of 8.8%, 11.4% and 26.3%, respectively, compared with 5.5% for patients without acute kidney injury. Additionally, acute kidney injury (hazard ratio, 1.7; 95% confidence interval, 1.28-2.13; P < 0.001) and maximum RIFLE class I (hazard ratio, 1.4; 95% confidence interval, 1.02-1.88; P = 0.037) and class F (hazard ratio, 2.7; 95% confidence interval, 2.03-3.55; P < 0.001) were associated with hospital mortality after adjusting for multiple covariates. CONCLUSION: In this general intensive care unit population, acute kidney 'risk, injury, failure', as defined by the newly developed RIFLE classification, is associated with increased hospital mortality and resource use. Patients with RIFLE class R are indeed at high risk of progression to class I or class F. Patients with RIFLE class I or class F incur a significantly increased length of stay and an increased risk of inhospital mortality compared with those who do not progress past class R or those who never develop acute kidney injury, even after adjusting for baseline severity of illness, case mix, race, gender and age.

Acute Kidney Injury↗
PubMed2006

Epidemiological evidence for an association between habitual tea consumption and markers of chronic inflammation.

BACKGROUND: Tea consumption has been inversely related to the risk of cardiovascular disease, but the mechanism behind this cardioprotective role is not fully understood. In vitro and animal model studies suggest an anti-oxidative and/or anti-inflammatory role. We aimed at investigating the association between tea drinking and indicators of low-grade inflammation in humans. METHODS: We used observational data from 1031 healthy men participating in a larger cross-sectional study (BELSTRESS). Tea consumption was determined according to a semi-quantitative food frequency questionnaire. Blood samples were analysed for C-reactive protein (CRP), serum amyloid A (SAA), serum haptoglobin and plasma fibrinogen. RESULTS: Of all participants, 22% consumed tea regularly while 10% drank more than two cups per day. Tea drinkers were less obese, smoked less and drank less alcohol and coffee. CRP, SAA and haptoglobin were significantly associated with tea consumption, the effect being graded for SAA. Multivariate analysis did confirm the independence of the observed beneficial role of tea drinking. Fibrinogen levels were however not different between habitual tea consumers and non-consumers. Coffee drinking proved unrelated to chronic inflammation. CONCLUSION: Tea drinking might be of interest in reducing the inflammatory process underlying cardiovascular disease. In light of the fact that tea is the most consumed beverage in the world after water, our findings might be of importance from a public health perspective.

Adult↗
PubMed2006

The reliability of two observation methods of nonblanchable erythema, Grade 1 pressure ulcer.

Accurate identification of nonblanchable erythema (NBE) is essential in pressure ulcer prevention. This descriptive study assessed interrater reliability between a researcher and trained nurses in observing blanchable erythema and NBE and examined the predictive validity and level of agreement between two observation methods for NBE. Findings suggest that the transparent disk method should be preferred to the finger method. The interrater reliability between the researcher and the nurses was substantial and was higher for the observations at the sacrum than for those at the heels. Educational level and years of nursing experience did not seem to influence interrater reliability.

Adult↗
PubMed2006

Validity and reproducibility of a semi-quantitative food-frequency questionnaire for estimating calcium intake in Belgian preschool children.

Relative validity and reproducibility of a semi-quantitative food-frequency questionnaire (FFQ) for measuring preschool children's usual Ca intake were assessed using parents or guardians as a proxy. Estimated diet records (EDR; 3 d) were used as the reference method and reproducibility was measured by repeated FFQ administrations 5 weeks apart. From 2095 preschool children (2.5-6.5 years) randomly selected in Flanders (Flemish region of Belgium), 1052 returned a FFQ and EDR. Stringent exclusion procedures reduced the sample for validity analyses to 509 children. From a separate sample of 244 preschool children, 124 returned two FFQ, of whom sixty were included in the reproducibility analysis. Mean Ca intakes were 838 (sd 305) and 777 (sd 296) mg/d for EDR and FFQ respectively, indicating a mean difference of 60.9 (sd 294.4) mg/d (P<0.001). Pearson's correlation was 0.52. Cross-classification analysis of the FFQ and EDR classified 83 % of the subjects in the same or adjacent category and 2.4 % in extreme quartiles. Actual values for surrogate FFQ quartiles showed a progressive increase in Ca intake (P<0.001). The FFQ correctly identified 77 % of the children consuming less Ca than the age-specific RDA (800 mg/d). Correlation between repeated administrations was 0.79. No significant difference between mean Ca intakes was established by two administrations (23.8 (sd 161.2) mg/d). Cross-classification of repeated administrations classified 93.4 % of the subjects in the same or adjacent category and no subjects in extreme categories. This FFQ tended to underestimate preschool children's Ca intake when administered by a proxy. However, it demonstrated good repeatability and fairly good ability to classify subjects into extremes of Ca intake.

Belgium↗
PubMed2006

How to improve screening in first-degree relatives of patients with premature coronary heart disease.

BACKGROUND: Guidelines on the prevention of cardiovascular disease recommend screening in close relatives of patients with premature coronary heart disease (CHD). This family history puts them at increased risk for CHD, independent of other major risk factors, but screening for CHD risk factors in these relatives is not widely practiced in Europe. This demonstration project examined how to improve screening of close relatives of patients with premature CHD in daily practice. METHODS: A controlled study design was used. Four hospitals were compared in a pre-test as to the actual screening of relatives of patients with premature CHD. Then they were arranged in pairs and randomly assigned to the Usual care (U) or Intervention group (I). An information and health education program--involving patients, relatives and family doctors--was developed in I to improve screening by the family doctor. RESULTS: The pre-test confirmed that screening of relatives of patients with premature CHD is poorly practiced in the four regions; no significant differences between I and U were observed. The screening of relatives during the study period reached 63.9% in I compared to 25.4% in U. This difference between I and U was present in siblings and offspring. The cardiovascular risk profile of the relatives of I was not optimal and needed improvement. CONCLUSION: Screening of first-degree relatives of patients with premature CHD can be significantly improved through a health education program. This is the first and necessary step to improve the management of risk factors in these people, who are at increased risk for CHD.

Adult↗
PubMed2006

Are serum leptin and the Gln223Arg polymorphism of the leptin receptor determinants of bone homeostasis in elderly men?

OBJECTIVE: Across studies it has been suggested that leptin intervenes as a regulator of bone metabolism. This study assesses the contribution in elderly men of leptin and the Gln223Arg leptin receptor gene (LEPR) polymorphism to the variation in bone homeostasis, in relation to body composition and free estradiol as major confounders. DESIGN: We performed cross-sectional (n = 270) and longitudinal (mean follow-up 3.4 years, n = 214) evaluations in elderly men. METHODS: Serum leptin, LEPR genotype, baseline bone mineral density (BMD), longitudinal BMD changes at the hip and forearm, and biochemical markers of bone turnover were determined. RESULTS: In cross-sectional analyses absolute fat mass was the index of body composition most strongly associated with leptin (r = 0.74; P < 0.001). LEPR genotypes and serum leptin were not associated. Serum bone-specific alkaline phosphatase (S-BAP) was associated with LEPR genotypes (P = 0.05) and urinary C-terminal telopeptides of type I collagen (U-CTX) were associated with leptin levels (P = 0.03), independently from age, fat mass and free estradiol. Baseline BMD at the hip and forearm was neither associated with leptin nor with LEPR genotypes. Prospectively assessed BMD loss was not associated with serum leptin at the hip, whereas BMD loss was positively associated with leptin at the forearm (P = 0.01), independently from age, fat mass and free estradiol. Longitudinal changes in hip or forearm BMD were not associated with LEPR genotypes. CONCLUSION: The findings suggest a possible role for leptin as determinant of bone homeostasis in elderly men, but with only modest impact independently from body composition and free estradiol.

Aged↗
PubMed2006

Long-term changes in the perception of job characteristics: results from the Belstress II--study.

The aim was to explore long-term changes in the perception of job characteristics--based on the Job Content Questionnaire (JCQ)--in view of the changing labor market in Western societies. A total number of 2,821 workers from nine companies were involved in the longitudinal Belstress-project. Data were gathered on two occasions with a mean time interval of 6.6 yr. At both times, participants completed the JCQ which measures the perception of job demands, job control and social support. In addition, the instrument contains questions regarding physical job demands, job insecurity and impact of world market competition (WMC). Changes over time in the perception of the different dimensions of the JCQ were evaluated within a sample of 2,490 respondents who remained in the same job. A statistically significant long-term stability of all JCQ scales was found. As far as intra-individual changes over time are concerned, the population showed a modest average increase in the perception of job demands, control and support of approximately 3%. Long-term changes in the other scales were larger, with an average increase of 10.3% in job insecurity and 15.5% in impact of WMC. Substantial variation in these two scales was found at the level of the company and in some socio-demographic factors. While perceived job characteristics remained relatively stable over an average period of 6.6 yr, a substantial increase was noted in job insecurity and the impact of WMC. These dimensions are becoming increasingly important within the context of economic globalization and labor market flexibility.

Adult↗
PubMed2006

Validity of parentally reported weight and height for preschool-aged children in Belgium and its impact on classification into body mass index categories.

OBJECTIVE: The aim of this study was to evaluate the validity of parentally reported weight and height values for preschool-aged children (3-7 years of age) in Belgium and the accuracy of BMI classifications using those data. METHODS: The subjects were 297 preschool-aged children (157 boys and 140 girls). A questionnaire with questions about height and weight was distributed to the children and completed by their parents. Nurses of the Centres for Pupils Counselling conducted anthropometric measurements by following standardized procedures. National and international age- and gender-specific BMI cutoff values were used to determine BMI categories. RESULTS: Mean differences between reported and measured values for weight (-0.57 kg) and BMI (-0.51 kg/m2) were statistically significant, although small. For height, the mean difference (0.14 cm) was not statistically significant. When national and international BMI cutoff values for overweight were used, sensitivity values were 47% and 44%, respectively, and specificity values were 94% and 95%. Among all children requiring nutritional advice on the basis of being overweight or obese, more than one half of the overweight children and >75% of the obese children would be missed with the use of parentally reported weight and height values. Conversely, 70% of the children being classified as underweight with the use of these reported data could be encouraged wrongly to gain weight. The bias of parent-reported BMI values was significantly greater when weight and height were both guessed, rather than being measured at home. CONCLUSIONS: Our results show the inaccuracy of parentally reported weight and height values in Belgium for classifying preschool-aged children into BMI categories. Therefore, accurate measurements of weight and height should be encouraged in studies in which BMI of children is a variable of interest.

Belgium↗
PubMed2005

Vitamin D binding protein, bone status and body composition in community-dwelling elderly men.

The vitamin D binding protein (DBP) is the major carrier protein for vitamin D metabolites in plasma. Polymorphisms in DBP have been described to be associated with an increased bone fracture risk and diabetes. The present study investigates the influence of both phenotypic and (TAAA)(n)-Alu repeat DBP-polymorphism and DBP-concentration on bone mineral density, body composition, bone turnover- and metabolic markers in a cohort of ambulatory elderly men. We included 211 men (>70 years) in this study. Bone mineral density (BMD) was determined by dual energy X-ray absorptiometry. Bone turnover was assessed by measurement of serum osteocalcin, serum and urinary C-terminal telopeptides of type I collagen and urinary deoxypyridinoline, together with 25(OH)-vitamin D and 1,25(OH)(2)-vitamin D concentrations. DBP-phenotypes were determined electrophoretically and the (TAAA)(n)-Alu repeat polymorphism was determined by polymerase chain reaction. Body composition was estimated using bioelectrical impedance analysis, together with handgrip and arm strength, fasting serum glucose and leptin concentrations. No differences in BMD or bone turnover markers among DBP-phenotypes or (TAAA)(n)-genotypes were observed in this study. Serum 25(OH)-vitamin D was comparable among DBP-variants and did not relate to DBP-concentrations, whereas 1,25(OH)(2)-vitamin D was different among DBP-phenotypes and was correlated positively with DBP-concentrations. DBP-concentrations related positively to body mass index, fat mass, leptin and glucose concentration. The correlation with leptin remained significant after correction for fat mass. Fasting glucose concentrations were different among DBP-phenotypes, whereas no difference was observed between (TAAA)(n)-genotypes. In conclusion, serum 1,25(OH)(2)-vitamin D concentrations are codetermined by DBP-phenotypes and DBP-concentrations. No major effect of DBP-polymorphism was demonstrated on BMD, bone turnover markers or body composition.

Absorptiometry, Photon↗
PubMed2005

The prevalence of concomitant hypertension and hypercholesterolaemia in the general population.

OBJECTIVE: To study the joint prevalence of elevated blood pressure and raised total cholesterol in adult individuals and to estimate the multifactorial cardiovascular risk associated with this clustering. MATERIAL AND METHODS: Data were obtained through pooling of databases from large cross-sectional representative population-based studies carried out in Belgium. Prevalences of concurrent hypertension (systolic/diastolic blood pressure > or =140/90 mm Hg and/or under antihypertensive treatment) and hypercholesterolaemia (total cholesterol > or =190 mg/dl and/or using lipid-lowering drugs) were determined as well as the proportion of high risk individuals (according to SCORE) in this particular subgroup. RESULTS: In total, 16,300 men and 5075 women aged 35-74 years were included. The prevalences of hypertension and hypercholesterolaemia were, respectively, 41% and 84% in men and 31% and 82% in women. Both risk factors occurred simultaneously in 38% of men and 32% of women. In multivariate analysis, risk factor clustering was increasing with age and body mass index but appeared less prominent among smokers. Only 20% of all subjects having both risk factors were reaching a high multifactorial risk level of 5%. CONCLUSIONS: The high prevalence of co-existing hypertension and hypercholesterolaemia further accentuates the need for adequate risk factor management in this substantial subgroup of our population especially in younger subjects.

Adult↗
PubMed2005

The importance of standardization of creatinine in the implementation of guidelines and recommendations for CKD: implications for CKD management programmes.

BACKGROUND: In an attempt to reduce late referral and to improve the care of patients with chronic kidney disease (CKD), different organizations have issued guidelines on when to refer patients to the nephrologist. Most suggest referral of patients with a GFR below 60 ml/min/1.73 m2, and demand referral if the GFR is below 30 ml/min/1.73 m2. It is recommended to use the abbreviated MDRD equation to estimate GFR. This formula is, however, sensitive to the creatinine assay methodology. In addition, the impact of the implementation of such guidelines on the nephrology practice has never been evaluated. This study (i) identifies the true burden of CKD in a population and simulates the effects of a 100% implementation of the guidelines on the nephrology work load, and (ii) evaluates the validity of the estimated GFR using the abbreviated MDRD formula when routinely provided. METHODS: Different laboratories (both hospital and private) in our region were asked to report on all the serum creatinine values performed during the first week of December 2004. If patients had more than one determination, only the lowest serum creatinine value was retained. Patients already known to a nephrology unit were not included. GFR was calculated using the abbreviated MDRD, using the serum creatinine as reported by these laboratories, or after correction to the MDRD-standard using different published equations. RESULTS: 20,108 patients, with a mean age of 53.4+/-16.2 years, 48% females, had at least one serum creatinine determination in the observation period. According to the K/DOQI CKD classification, 20.2, 1.6 and 0.8% of females and 13.3, 1.6 and 0.6% of males were in stage 3, 4 and 5, respectively, when the abbreviated MDRD formula was used with the serum creatinine value as reported by the laboratories. Important differences in classifications were obtained when the different correction formulae for creatinine were applied. According to the current recommendations, this would lead to a mandatory referral of 1650-2400 CKD stage 4 patients per 100 000 inhabitants and a suggested referral of another 4100-15 360 CKD stage 3 patients per 100,000 inhabitants to a nephrology unit. CONCLUSION: Implementation of the current guidelines for referral of CKD patients to nephrologists would lead to an overload of the nephrology care capacities. Large differences in estimated GFRs with different corrections for serum creatinine are observed, resulting in important CKD classification differences. Standardization of serum creatinine assays is mandatory before guidelines, and especially the routine provision of the estimated GFR by the abbreviated MDRD formula, can be implemented in clinical practice.

Adult↗
PubMed2005

Smoking behaviour in European patients with established coronary heart disease.

AIMS: Treatment guidelines for patients with established coronary disease emphasize the importance of smoking cessation. We aimed to study smoking behaviour in European patients, as well as trends in this behaviour over time. We further aimed to evaluate the relation between selected patient characteristics and smoking cessation. METHODS AND RESULTS: We studied patients who were enrolled in the second European Action on Secondary Prevention through Intervention to Reduce Events (EUROASPIRE) survey, which was undertaken in 15 European countries during 1999-2000. Consecutive patients, < or =70 years were identified after coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, admission for myocardial infarction, or admission for myocardial ischaemia. Patients were then interviewed, at a median of 1.5 years after the index event. During the interview, data were collected on a broad range of clinical characteristics, including smoking status, which was validated by breath carbon monoxide levels. The prevalence of smoking was compared with data from the first EUROASPIRE survey, which had a similar design, and was conducted during 1995-96. In EUROASPIRE II, 5551 patients attended the interview and 1172 (21%) were (persistent) smokers. No decrease in smoking prevalence was observed similar to the first survey (19%). The proportion of smokers was 39% in patients aged <50, 26% in patients aged 50-60, and 14% in patients aged > or =60. Men and women had similar prevalence. A verbal advice to give up smoking by a medical professional was given to 99% of the 2244 pre-event smokers, and 48% actually stopped. This proportion was relatively high in elderly patients > or =60 years (53%), patients with a university level of education (56%), and patients with a myocardial infarction as the index event (52%). The proportion of stopped smokers was low in patients <50 years (41%) and in patients with myocardial ischaemia as the index event (38%). CONCLUSION: The prevalence of smoking in European patients with established coronary disease is too high: one out of each five patients smokes, despite a personal advice to stop. Thus, still there is a need for the development of effective smoking cessation programmes.

Adult↗
PubMed2005

Plasma N-terminal pro-brain natriuretic peptide concentration predicts coronary events in men at work: a report from the BELSTRESS study.

AIMS: Increased levels of neurohormonal markers, including the N-terminal fragment of pro-brain natriuretic peptide (NT-pro-BNP), have been shown to be of prognostic significance in patients with heart failure or coronary heart disease (CHD). The aim of this study was to study the predictive value of NT-pro-BNP for coronary events in a middle-aged population of men at work. METHODS AND RESULTS: A nested case-control study was performed in a large cohort of over 10 000 men at work (aged 35-59) after a median follow-up of 2.66 years. In total, 66 individuals who developed coronary events were matched on a 3-to-1 basis to 198 controls free of coronary events during follow-up. Besides clinical characteristics and conventional cardiac risk factors, NT-pro-BNP (electrochemiluminiscence assay, Roche diagnostics) and serum creatinine levels were determined. In univariable analysis, cases were more frequently current smokers and diabetics, had more frequently a history of CHD, and had higher levels of total cholesterol and systolic blood pressure (SBP), and lower levels of HDL cholesterol. A highly significant difference (P < 0.0001) was noted for NT-pro-BNP levels between cases (median 48.5 pg/mL, interquartile range 26.4-116.6 pg/mL) and controls (30.0 pg/mL, 19.5-47.6 pg/mL). In multivariable conditional logistic regression analysis, NT-pro-BNP remained strongly associated with risk for coronary events [third vs. first tertile, odds ratio (95% CI) 3.24 (1.18-8.85)], independent of body mass index, smoking, diabetes, SBP, total and HDL cholesterol, creatinine, and previous CHD. CONCLUSION: NT-pro-BNP is a strong predictor of coronary events in men at work after a relatively short period, even after adjustment for conventional risk factors.

Adult↗