Biomarkers' 'ability to improve prediction of cardiovascular disease risk is low

Measurement of known biological markers of cardiovascular disease slightly improved the forecasting ability of future myocardial infarction or stroke in healthy people, but not enough for preventive therapies. The study, led by the investigators, Massachusetts General Hospital (MGH) and the University of Lund in Sweden, in the July 1st Journal of the American Medical Association.

"If there is not currently appear to be a role for the use of biomarkers in the study of cardiovascular disease risk, our data does not allow for biomarkers for a role in some patients," explains Thomas Wang , MD, of MGH Cardiology Center, the study of co-senior and corresponding author. "We remain optimistic that new technologies enable the discovery of biomarkers, which help us towards providing truly individual cardiovascular, forecasting Risk. "

Although traditional risk factors - such as smoking, hypertension, cholesterol and age - to identify individuals in the highest risk of heart attack or stroke, many people without these always factors of these potentially devastating events. Given that preventive measures such as changes in lifestyle and use of statins, drugs used to control high cholesterol may reduce the risk, the authors note, it is necessary for man, whose risk could be reduced by changes in behavior or treatment. Some previous studies of the prediction of cardiovascular disease by biomarkers of risk - the laboratory biosafety United could have prognostic benefits - focuses on groups, we know already that it is' high risk and others do not check whether the information, the biomarkers could indeed change the risk classification. This study was designed to these restrictions.

The researchers focused on two biomarkers have been widely studied in cardiovascular diseases - C-reactive protein (CRP) and N-Terminal Pro-B-type natriuretic peptide (N-BNP) - and in four of recently were part of cardiovascular disease - risk - cystatin C, Lp-PLA2, proADM MR and MR-proANP. You entered more than 5,000 participants in the Malmö Diet and Cancer Study (MDC), during a prospective study, which at the University of Lund, for both conventional cardiovascular risk of data and samples of plasma are available. The researchers analyzed plasma levels of the six biomarkers in samples which, if the participants in the MDC, then using a personal identification number for each Swedish citizen, sought information on securities and coronary disease in the databases of hospital events, stroke and causes of death over an average of nearly 13 years.

Two of biomarkers - N-BNP and MR-proADM - have been marked improvement in the prediction of coronary events, defined as myocardial infarction or death from coronary heart disease. N-BNP and C-reactive protein to improve the prediction of cardiovascular disease events, coronary events and stroke. But if the possibility of biomarkers for certain patients at higher risk or lower analyzed the potential impact on treatment decisions was minimal.

"Since the election of treatment depends on the level of risk a patient enters the movement of patients between categories of risks can lead to a change in therapy," says co-author Christopher Newton-Chehem, MD, MPH, MGH Heart Center. "While there was more movement under the category of participants at the outset as an intermediate risk, first that the movement has resulted in lower risk, so we are always the search for biomarkers of a clinically significant difference in the prediction of cardiovascular disease - cardiovascular risk. Wang and Newton-Chehem are both professors of medicine at Harvard Medical School.