Research Studies
|
July 19, 2024

Improved Risk Prediction for Heart Failure and Mortality with Cardiovascular Biomarkers

Written By
Medically Reviewed by
Updated On
September 17, 2024

Cardiovascular diseases (CVDs) are the leading cause of death globally, claiming nearly 18 million lives each year. Early detection and prevention are crucial in reducing its impact and saving lives. One way to improve our ability to predict and prevent heart-related conditions is through understanding cardiovascular biomarkers.Β 

A recent study published in JAMA examined the value of cardiovascular biomarkers in predicting heart disease and other related conditions. By integrating these biomarkers into routine assessments, doctors could potentially tailor prevention strategies more effectively, especially for high-risk individuals.

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What Are Cardiovascular Biomarkers?

Cardiovascular biomarkers are substances in the body that can be measured to evaluate heart health. These biomarkers can be found in blood, other body fluids, or tissues and are typically proteins, enzymes, or other molecular substances. They play a critical role in diagnosing and managing various cardiovascular conditions, including heart failure, heart attacks, and ongoing heart damage.

The Study At A Glance

The study was an individual-level data analysis, pooling information from 28 general population-based cohorts across 12 countries and four continents. A total of 164,054 individuals participated in the study, with a median age of 53.1 years. The participants were almost evenly split by gender, with 52.4% being women.

Biomarkers Measured

The primary biomarkers measured in the study included:

  • High-sensitivity cardiac troponin I and T (markers of heart muscle damage)
  • N-terminal pro-B-type natriuretic peptide (indicator of heart failure)
  • B-type natriuretic peptide (indicator of heart failure)
  • High-sensitivity C-reactive protein (a marker of inflammation)

These biomarkers were quantitatively assessed through blood samples collected from the participants at various points during the study period.

Outcomes Measured

  • Primary Outcome: The main focus was on incident atherosclerotic cardiovascular disease, which includes both fatal and nonfatal events such as heart attacks and strokes.
  • Secondary Outcomes: These included all-cause mortality, heart failure, ischemic stroke, and myocardial infarction.

Key Findings

The key findings of the study include:

  • Association with Cardiovascular Events: All the biomarkers studied were significantly associated with the incidence of atherosclerotic cardiovascular disease.Β 
  • Improvement in Risk Prediction: Adding these biomarkers to models that already include established risk factors (like blood pressure and cholesterol levels) improved the C statistic, which measures the accuracy of predictive models. The modest improvement suggests that biomarkers provide additional predictive value over traditional risk factors.
  • Secondary Outcomes: The biomarkers also showed strong associations with secondary outcomes such as all-cause mortality and heart failure. The improvements in risk prediction were most pronounced for these secondary outcomes, suggesting that the biomarkers have a more favorable impact on predicting more severe health outcomes.
  • Greater Benefit in Older Adults: The incremental value of adding these biomarkers to risk prediction models was more significant in individuals 65 years or older than in younger people. This finding indicates that biomarkers could be especially beneficial for identifying high-risk individuals in older populations.

Key Insights To Implement

The findings from the study on cardiovascular biomarkers have several practical implications for healthcare practice, public health policy, and individual health management. Here’s a detailed look at the practical applications of the study’s results:

1. Healthcare Impact: Influencing Primary Prevention Strategies

The findings from the study on cardiovascular biomarkers can significantly influence primary prevention strategies in several ways:

  • Risk Stratification: Healthcare providers can use biomarker levels to more accurately stratify patients into different risk categories. This stratification allows for the implementation of personalized prevention strategies tailored to each patient's risk level, ensuring those at higher risk receive more intensive interventions.
  • Guideline Integration: Medical guidelines could be updated to include biomarker testing as part of the routine assessment for cardiovascular risk. This addition would help clinicians incorporate biomarker data into their clinical decision-making processes, making prevention strategies more data-driven.
  • Community Health Programs: Public health initiatives can incorporate biomarker screening to identify at-risk populations at the community level, especially in areas with a high prevalence of cardiovascular diseases. The inclusion of these biomarkers can lead to targeted community health interventions to reduce risk factors through lifestyle modifications, education, and outreach programs.

2. Patient Benefits: Improving Outcomes Through Early Identification

Early identification of elevated cardiovascular risk through biomarkers offers substantial benefits for patients:

  • Early Intervention: Identifying high-risk individuals before the onset of disease allows for earlier intervention, which can include lifestyle changes, pharmacotherapy, or closer monitoring. Early interventions can slow disease progression, reduce the severity of heart conditions, or even prevent them entirely.
  • Improved Management Plans: With detailed risk profiles enhanced by biomarker data, healthcare providers can develop more effective management plans that are specifically tailored to individual needs, which can lead to better clinical outcomes.
  • Enhanced Patient Engagement: Knowing their biomarker status can motivate patients to become more engaged in managing their health. This can lead to improved compliance with prescribed interventions and lifestyle adjustments.

Lab Tests for Cardiovascular Biomarkers

Rupa Health provides access to several key cardiovascular biomarker tests that can help assess heart health and the risk of cardiovascular disease. These tests include:

[signup]

Key Takeaways

  • Cardiovascular biomarkers such as high-sensitivity cardiac troponins and B-type natriuretic peptides marginally improve risk prediction for atherosclerotic cardiovascular disease when added to existing risk factors.
  • These biomarkers show a more substantial predictive value for heart failure and overall mortality than for atherosclerotic events alone.
  • The study suggests greater benefits in using these biomarkers for older adults (aged 65 and above) compared to younger populations.

Cardiovascular diseases (CVDs) are the leading cause of death globally, claiming nearly 18 million lives each year. Early detection and prevention are crucial in reducing its impact and saving lives. One way to improve our ability to predict and support heart health is through understanding cardiovascular biomarkers.Β 

A recent study published in JAMA examined the value of cardiovascular biomarkers in predicting heart disease and other related conditions. By integrating these biomarkers into routine assessments, doctors could potentially tailor prevention strategies more effectively, especially for individuals who may be at higher risk.

[signup]

What Are Cardiovascular Biomarkers?

Cardiovascular biomarkers are substances in the body that can be measured to evaluate heart health. These biomarkers can be found in blood, other body fluids, or tissues and are typically proteins, enzymes, or other molecular substances. They play a critical role in supporting the diagnosis and management of various cardiovascular conditions, including heart failure, heart attacks, and ongoing heart damage.

The Study At A Glance

The study was an individual-level data analysis, pooling information from 28 general population-based cohorts across 12 countries and four continents. A total of 164,054 individuals participated in the study, with a median age of 53.1 years. The participants were almost evenly split by gender, with 52.4% being women.

Biomarkers Measured

The primary biomarkers measured in the study included:

  • High-sensitivity cardiac troponin I and T (markers of heart muscle health)
  • N-terminal pro-B-type natriuretic peptide (indicator of heart function)
  • B-type natriuretic peptide (indicator of heart function)
  • High-sensitivity C-reactive protein (a marker of inflammation)

These biomarkers were quantitatively assessed through blood samples collected from the participants at various points during the study period.

Outcomes Measured

  • Primary Outcome: The main focus was on incident atherosclerotic cardiovascular disease, which includes both fatal and nonfatal events such as heart attacks and strokes.
  • Secondary Outcomes: These included all-cause mortality, heart failure, ischemic stroke, and myocardial infarction.

Key Findings

The key findings of the study include:

  • Association with Cardiovascular Events: All the biomarkers studied were significantly associated with the incidence of atherosclerotic cardiovascular disease.Β 
  • Improvement in Risk Prediction: Adding these biomarkers to models that already include established risk factors (like blood pressure and cholesterol levels) improved the C statistic, which measures the accuracy of predictive models. The modest improvement suggests that biomarkers provide additional predictive value over traditional risk factors.
  • Secondary Outcomes: The biomarkers also showed strong associations with secondary outcomes such as all-cause mortality and heart failure. The improvements in risk prediction were most pronounced for these secondary outcomes, suggesting that the biomarkers have a more favorable impact on predicting more severe health outcomes.
  • Greater Benefit in Older Adults: The incremental value of adding these biomarkers to risk prediction models was more significant in individuals 65 years or older than in younger people. This finding indicates that biomarkers could be especially beneficial for identifying individuals who may be at higher risk in older populations.

Key Insights To Implement

The findings from the study on cardiovascular biomarkers have several practical implications for healthcare practice, public health policy, and individual health management. Here’s a detailed look at the practical applications of the study’s results:

1. Healthcare Impact: Influencing Primary Prevention Strategies

The findings from the study on cardiovascular biomarkers can significantly influence primary prevention strategies in several ways:

  • Risk Stratification: Healthcare providers can use biomarker levels to more accurately stratify patients into different risk categories. This stratification allows for the implementation of personalized prevention strategies tailored to each patient's risk level, ensuring those at higher risk receive more intensive interventions.
  • Guideline Integration: Medical guidelines could be updated to include biomarker testing as part of the routine assessment for cardiovascular risk. This addition would help clinicians incorporate biomarker data into their clinical decision-making processes, making prevention strategies more data-driven.
  • Community Health Programs: Public health initiatives can incorporate biomarker screening to identify at-risk populations at the community level, especially in areas with a high prevalence of cardiovascular diseases. The inclusion of these biomarkers can lead to targeted community health interventions to reduce risk factors through lifestyle modifications, education, and outreach programs.

2. Patient Benefits: Improving Outcomes Through Early Identification

Early identification of elevated cardiovascular risk through biomarkers offers substantial benefits for patients:

  • Early Intervention: Identifying individuals who may be at higher risk before the onset of disease allows for earlier intervention, which can include lifestyle changes, pharmacotherapy, or closer monitoring. Early interventions can help manage disease progression and reduce the severity of heart conditions.
  • Improved Management Plans: With detailed risk profiles enhanced by biomarker data, healthcare providers can develop more effective management plans that are specifically tailored to individual needs, which can lead to better clinical outcomes.
  • Enhanced Patient Engagement: Knowing their biomarker status can motivate patients to become more engaged in managing their health. This can lead to improved compliance with prescribed interventions and lifestyle adjustments.

Lab Tests for Cardiovascular Biomarkers

Rupa Health provides access to several key cardiovascular biomarker tests that can help assess heart health and the risk of cardiovascular disease. These tests include:

[signup]

Key Takeaways

  • Cardiovascular biomarkers such as high-sensitivity cardiac troponins and B-type natriuretic peptides may help improve risk prediction for atherosclerotic cardiovascular disease when added to existing risk factors.
  • These biomarkers show a more substantial predictive value for heart failure and overall mortality than for atherosclerotic events alone.
  • The study suggests greater benefits in using these biomarkers for older adults (aged 65 and above) compared to younger populations.
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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Lab Tests in This Article

Anderson, S. (2022, May 19). 6 Preventable Risk Factors Associated With Heart Attacks. Rupa Health. https://www.rupahealth.com/post/5-things-to-do-after-a-heart-attack

C-Reactive Protein, High Sensitivity (CRP, HS) by Access Med Labs. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/access-medical-labs-c-reactive-protein-high-sensitivity-crp-hs

Cardiovascular Testing. (n.d.). Rupa Health. Retrieved May 15, 2024, from https://www.rupahealth.com/health-categories/cardiovascular

Cloyd, J. (2023, April 7). Functional medicine high cholesterol protocol. Rupa Health. https://www.rupahealth.com/post/functional-medicine-high-cholesterol-protocol

DePorto, T. (2022, December 9). Worried About Heart Disease? Ask Your Provider for These 6 Specialty Labs at Your Next Appointment. Rupa Health. https://www.rupahealth.com/post/worried-about-heart-disease-ask-your-provider-for-these-6-specialty-labs-at-your-next-appointment

Filipovic, M. G., & Luedi, M. M. (2023). Cardiovascular biomarkers: Current status and future directions. Cells, 12(22), 2647. https://doi.org/10.3390/cells12222647

High Sensitivity C-Reactive Protein (hs-CRP) by BostonHeart Diagnostics. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/bostonheart-high-sensitivity-c-reactive-protein-hs-crp

High Sensitivity C-Reactive Protein (hsCRP) by ZRT Laboratory. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/zrt-laboratory-high-sensitivity-c-reactive-protein-hscrp

Khakham, C. (2023, April 6). Understanding Your Risk of Cardiovascular Disease With Functional Medicine Labs. Rupa Health. https://www.rupahealth.com/post/understanding-your-risk-of-cardiovascular-disease-with-functional-medicine-labs

N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) by BostonHeart Diagnostics. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/bostonheart-n-terminal-pro-brain-natriuretic-peptide-nt-probnp

Neumann, J. T., Twerenbold, R., Weimann, J., Ballantyne, C. M., Benjamin, E. J., Costanzo, S., de Lemos, J. A., deFilippi, C. R., Di Castelnuovo, A., Donfrancesco, C., DΓΆrr, M., Eggers, K. M., EngstrΓΆm, G., Felix, S. B., Ferrario, M. M., Gansevoort, R. T., Giampaoli, S., Giedraitis, V., Hedberg, P., & Iacoviello, L. (2024). Prognostic Value of Cardiovascular Biomarkers in the Population. JAMA. https://doi.org/10.1001/jama.2024.5596

Troponin T Gen 5 by BostonHeart Diagnostics. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/bostonheart-troponin-t-gen-5

WHO. (2023). Cardiovascular diseases. Www.who.int. https://www.who.int/health-topics/cardiovascular-diseases#:~:text=Cardiovascular%20diseases%20(CVDs)%20are%20the

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