Biomarkers Only Small Help in Predicting Heart, Stroke Risk
Biomarkers not much more useful than conventional risk factors
WEDNESDAY, Dec. 20 (HealthDay News) -- A study of 10 biomarkers has found that they are not much more useful than conventional risk factors in determining the risk of cardiovascular disease and death, according to a report in the Dec. 21 issue of the New England Journal of Medicine.
Thomas J. Wang, M.D., from Massachusetts General Hospital in Boston, and colleagues examined the levels of 10 biomarkers from different biological pathways in 3,209 individuals in the Framingham Heart Study. The biomarkers were C-reactive protein, B-type natriuretic peptide, N-terminal pro-atrial natriuretic peptide, aldosterone, renin, fibrinogen, D-dimer, plasminogen-activator inhibitor type 1, homocysteine, and the urinary albumin-to-creatinine ratio.
After a median follow-up of 7.4 years, 207 individuals died and 169 had a first major cardiovascular event. Six biomarkers most strongly predicted risk of death, with adjusted hazard ratios per one standard deviation increment ranging from 1.17 to 1.4. Two biomarkers most strongly predicted major cardiovascular events, with adjusted hazard ratios of 1.25 and 1.2.
Using multimarker scores, the investigators found that those in the highest 20 percent had significantly higher risks of death (adjusted hazard ratio 4.08) and major cardiovascular events (adjusted hazard ratio 1.84) compared with the bottom 40 percent. However, this score only slightly increased the ability to classify risk compared with conventional risk factors.
The study "shows us how difficult it is to achieve effective risk stratification with respect to multifactorial disease processes," states an accompanying editorial.