Multiple Biomarkers for the Prediction of First Major Cardiovascular Events and Death

In an analysis from the Framingham Heart Study, 10 biomarkers were evaluated for their ability to predict clinical outcomes. The addition of biomarkers to conventional risk factors resulted in significant increases in the hazard ratios for death and major cardiovascular events but only small increas...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 355; no. 25; pp. 2631 - 2639
Main Authors: Wang, Thomas J, Gona, Philimon, Larson, Martin G, Tofler, Geoffrey H, Levy, Daniel, Newton-Cheh, Christopher, Jacques, Paul F, Rifai, Nader, Selhub, Jacob, Robins, Sander J, Benjamin, Emelia J, D'Agostino, Ralph B, Vasan, Ramachandran S
Format: Journal Article
Language:English
Published: Boston, MA Massachusetts Medical Society 21.12.2006
Subjects:
Biological and medical sciences
Biomarkers
Biomarkers - blood
Biomarkers - urine
C-Reactive Protein - analysis
Cardiovascular disease
Cardiovascular Diseases - epidemiology
Cholesterol
Diabetes
Female
Follow-Up Studies
General aspects
Heart attacks
Homocysteine
Humans
Kaplan-Meier Estimate
Male
Medical sciences
Middle Aged
Mortality
Multivariate Analysis
Peptides
Plasminogen Activator Inhibitor 1 - blood
Prognosis
Proportional Hazards Models
Risk assessment
Risk Assessment - methods
Risk Factors
ROC Curve
Medicine
Multiple
Mortality
Prediction
Biological marker
Cardiovascular disease
Biological indicator
Death
Predictive factor
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In an analysis from the Framingham Heart Study, 10 biomarkers were evaluated for their ability to predict clinical outcomes. The addition of biomarkers to conventional risk factors resulted in significant increases in the hazard ratios for death and major cardiovascular events but only small increases in the C statistic for each end point. The incremental value of the assessment of biomarkers to the evaluation of established risk factors appears to be modest. The addition of biomarkers to conventional risk factors resulted in significant increases in the hazard ratios for death and major cardiovascular events but only small increases in the C statistic for each end point. Established cardiovascular risk factors, including dyslipidemia, smoking, hypertension, and diabetes mellitus, have been incorporated into algorithms for risk assessment in the general population, 1 , 2 but these characteristics do not fully explain cardiovascular risk. 3 – 5 There is substantial interest in the use of newer biomarkers to identify persons who are at risk for the development of cardiovascular disease and who could be targeted for preventive measures. 6 Many individual biomarkers have been related to cardiovascular risk in ambulatory persons, including levels of C-reactive protein, 7 , 8 B-type natriuretic peptide, 9 fibrinogen, 10 d-dimer, 11 and homocysteine. 12 Measurement of several biomarkers simultaneously (the “multimarker” approach) could enhance . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa055373