Adding cardiovascular biomarkers to established risk factors increases risk prediction


Adding cardiovascular biomarkers to established risk factors increases risk prediction

The addition of cardiovascular biomarkers to established risk factors leads to a small improvement in risk prediction of cardiovascular disease, according to a study published online May 13 in the Journal of the American Medical Association.

Johannes Tobias Neumann, M.D., Ph.D., from University Medical Center Hamburg-Eppendorf in Germany, and colleagues examined the prognostic value of routinely available cardiovascular biomarkers when added to established risk factors using data from 28 general population-based cohorts from 12 countries. The analyses included 164,054 individuals, with a median follow-up of 11.8 years.

The researchers identified 17,211 incident atherosclerotic cardiovascular disease events. Significant associations were seen for all biomarkers with incident atherosclerotic disease (subdistribution hazard ratio per 1-standard deviation change, 1.13, 1.18, 1.21, 1.14, and 1.14 for high-sensitivity cardiac troponin I, high-sensitivity cardiac troponin T, N-terminal pro-B-type natriuretic peptide, B-type natriuretic peptide, and high-sensitivity C-reactive protein, respectively) and for all secondary outcomes.

The C-statistic was improved with the addition of each single biomarker to a model that included established risk factors. In people younger than 65 years, the C-statistic for 10-year incident atherosclerotic cardiovascular disease improved from 0.812 to 0.8194 with the combination of high-sensitivity cardiac troponin I, N-terminal pro-B-type natriuretic peptide, and high-sensitivity C-reactive protein.

The most pronounced improvements in risk prediction were seen for the secondary outcomes of heart failure and all-cause mortality.

“The addition of biomarkers to established risk factors led to only a small improvement in risk prediction metrics for atherosclerotic cardiovascular disease, but was more favorable for heart failure and mortality,” the authors write.

More information:
Johannes Tobias Neumann et al, Prognostic Value of Cardiovascular Biomarkers in the Population, JAMA (2024). DOI: 10.1001/jama.2024.5596

Thomas A. Gaziano et al, Can Cardiovascular Risk Assessment Be Improved in the 21st Century?, JAMA (2024). DOI: 10.1001/jama.2024.7644

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Adding cardiovascular biomarkers to established risk factors increases risk prediction (2024, May 14)

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