Biomarkers' ability to improve prediction of heart risk minimal, say experts
1 Jul 2009, 1614 Hrs

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Washington, July 1 Researchers from Massachusetts General Hospital have revealed that measuring the known biomarkers modestly improves the prediction of future heart attack, but not enough to change preventive therapies.

Although conventional risk factors - like as smoking, hypertension, cholesterol levels and age - can identify individuals at the highest risk for heart attack or stroke, many people without these factors still experience these potentially devastating events.

"While there currently does not appear to be a role for routine use of biomarkers in screening for cardiovascular risk, our data do not exclude a role for biomarkers in selected patients," said Dr. Thomas Wang, of the MGH Heart Centre, the study's senior and co-corresponding author.

"We're still optimistic that new technologies will lead to the discovery of biomarkers that could help us move toward offering truly personalized cardiovascular risk prediction," he added.

The current study was focused on two biomarkers that have been extensively studied in cardiovascular disease - C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (N-BNP) - and four that recently have been identified as relating to cardiovascular risk - Cystatin C, Lp-PLA2, MR-proADM and MR-proANP.

The researchers found that two of the studied biomarkers - N-BNP and MR-proADM - did significantly improve the prediction of coronary events, defined as a heart attack or death from ischemic heart disease.

N-BNP and C-reactive protein improved the prediction of cardiovascular events, which are coronary events plus strokes.

But when the ability of biomarkers to move individual patients into higher- or lower-risk categories was analysed, the potential impact on treatment decisions was minimal.

"Since choice of therapies may depend on the risk category a patient falls into, moving patients between risk categories could lead to a change in therapy," said co-author Dr. Christopher Newton-Cheh, of MGH Heart Centre.

"While there was more category movement among participants initially classified as intermediate-risk, that resulted primarily from movement to lower risk levels, so we still need to find biomarkers that can make a clinically significant difference in predicting cardiovascular risk" he added.

The study appears in the Journal of the American Medical Association. (ANI)

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