Heart failure & cardiomyopathiesMeta-analysis
Prognostic Value of Cardiovascular Biomarkers in the Population
- Individual-level pooled analysis of population-based cohorts
- 28 cohorts
- 12 countries, 4 continents
Authors' conclusion
Cardiovascular biomarkers were strongly associated with fatal and nonfatal cardiovascular events and 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.
Study context
- Population
- General population; median age 53.1 years, 52.4% women; median follow-up 11.8 years
- Participants
- 164,054 participants · 28 cohorts
- Comparison
- Cardiovascular biomarkers added to established risk factors vs established risk factors alone
- Outcome
- Incident atherosclerotic CVD (all fatal and nonfatal events)
Pooled result
As reported in the abstract
Incident atherosclerotic CVD (17 211 events)
Subdistribution HR per 1-SD change (95% CI)
hs-cTnI
1.13(1.11–1.16)
hs-cTnT
1.18(1.12–1.23)
NT-proBNP
1.21(1.18–1.24)
BNP
1.14(1.08–1.22)
hs-CRP
1.14(1.12–1.16)
Further pooled results
10-year incident atherosclerotic CVD, age <65 years: C statistic, hs-cTnI + NT-proBNP + hs-CRP added
- C statistic, conventional model
- 0.812 (95% CI 0.8021-0.8208)
- C statistic, with biomarker combination
- 0.8194 (95% CI 0.8089-0.8277)
- Combination also improved reclassification vs conventional model
All-cause mortality, HF, ischemic stroke, MI
- All biomarkers significantly associated with all secondary outcomes
- Improvements in risk prediction most pronounced for HF and all-cause mortality
Incremental value of biomarkers by age
- Greater in people aged ≥65 years vs younger people
Original publication
Prognostic Value of Cardiovascular Biomarkers in the Population. JAMA. Published 11 June 2024. doi:10.1001/jama.2024.5596
Summarised from the published abstract; every number is checked against it