Biomarkers and cardiovascular events in patients with stable coronary disease in the ISCHEMIA Trials
Authors' conclusion
Among ISCHEMIA biorepository participants, biomarkers of myocyte injury/distension, inflammation, and platelet activity improved cardiovascular event prediction in addition to risk factors, LVEF, and assessments of ischemia and atherosclerosis severity.
Study context
- Population
- Stable outpatients with obstructive coronary artery disease (CAD) and moderate or severe inducible ischemia (ISCHEMIA biorepository)508 with computed cardiac tomographic angiography (CCTA)
- Participants
- 757 outpatients
- Primary endpoint
- CV death, MI, or hospitalization for unstable angina, HF, or resuscitated cardiac arrest
Methodological detailsbiorepository substudy, multimarker prognostic model
- Biorepository substudy
- Multimarker prognostic model
Primary result
As reported in the abstract
Primary outcome, adjusted HR per interquartile increase in biomarker (multimarker model) · median follow-up 3 (2-5) years
- High sensitivity troponin T (hsTnT), adjusted HR
- 1.58 (95% CI 1.22, 2.205)
- GDF-15, adjusted HR
- 1.60 (95% CI 1.16, 2.20)
- NT-proBNP, adjusted HR (95% 1.22, 2.14)
- 1.61
- sCD40L, adjusted HR (95% 1.12, 1.90)
- 1.46
- Primary outcome AUC, clinical model → multimarker model (P < .01)
- 0.710 to 0.792
Secondary outcomes
CV death or myocardial infarction (MI): AUC, clinical vs multimarker model
- AUC increased (P < .01)
- 0.714 to 0.783
Adjusted for core-lab confirmed atherosclerosis severity (CCTA)
- Similar findings
Original publication
Biomarkers and cardiovascular events in patients with stable coronary disease in the ISCHEMIA Trials. Am Heart J. Published 19 August 2023. doi:10.
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