Cardiovascular biomarkers strongly associated with fatal and nonfatal CV events and mortality: JAMA

The key findings of the study were as follows:

• The study analyzed data from 164,054 individuals across 28 population-based cohorts from 12 countries and 4 continents.

• All biomarkers, including 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, were significantly associated with incident ASCVD events and secondary outcomes such as all-cause mortality, heart failure, ischemic stroke, and myocardial infarction.

• Addition of each biomarker to established risk factor models improved the C statistic, with the combination of high-sensitivity cardiac troponin I, N-terminal pro-B-type natriuretic peptide, and high-sensitivity C-reactive protein showing the most substantial improvement in risk prediction for ASCVD, particularly in younger adults aged <65 years.

• However, the incremental value of biomarkers in improving risk prediction metrics for ASCVD was modest, although more favorable for heart failure and mortality outcomes.

While cardiovascular biomarkers were strongly associated with fatal and nonfatal cardiovascular events and mortality, their addition to established risk factors only marginally improved risk prediction for ASCVD. However, the incremental value of biomarkers was more pronounced for heart failure and mortality outcomes. These findings suggest that while biomarkers may offer some additional predictive value, their impact on overall risk prediction for ASCVD is limited, particularly in younger adults.

Reference:

Neumann JT, Twerenbold R, Weimann J, et al. Prognostic Value of Cardiovascular Biomarkers in the Population. JAMA. Published online May 13, 2024. doi:10.1001/jama.2024.5596