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Selecting Multiple Biomarker Subsets with Similarly Effective Binary Classification Performances
Published on: October 11, 2018
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Biomarker-based risk prediction in the community
Omar F AbouEzzeddine1,2, Paul M McKie1,2, Christopher G Scott3
1Cardiorenal Research Laboratory.
European Journal of Heart Failure
|November 5, 2016
Summary
N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hscTnI) best predict heart failure (HF) and major adverse cardiovascular events (MACE). Biomarker-guided prevention strategies show promise for reducing HF and MACE burden.
Area of Science:
- Cardiology
- Biomarker Discovery
- Preventative Medicine
Background:
- Cardiovascular biomarkers are crucial for predicting heart failure (HF) and major adverse cardiovascular events (MACE).
- Community-based strategies for HF and MACE prevention require effective biomarker guidance.
Purpose of the Study:
- To evaluate the predictive characteristics of multiple biomarkers for HF and MACE in a community cohort.
- To simulate the clinical implications of a biomarker-guided prevention strategy for HF and MACE.
Main Methods:
- Assessed predictive performance of galectin-3, ST2, hscTnI, hsCRP, NT-proBNP, and BNP in 1824 community participants.
- Conducted number needed to screen (NNS) and number needed to treat (NNT) analyses for biomarker-guided interventions.
- Simulated intervention effects based on biomarker positivity and efficacy.
Main Results:
- N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hscTnI) demonstrated superior predictive capabilities for both HF and MACE.
- A simulated NT-proBNP-guided intervention could reduce HF burden by ≥20% and MACE by ≥15% over 4 years.
- The NNS to prevent one HF event or MACE was ≤100, with NNTs of ≤20 for HF and ≤10 for MACE.
Conclusions:
- NT-proBNP and hscTnI are superior biomarkers for predicting HF and MACE in the community setting.
- Biomarker-guided preventative interventions, if effective, offer a favorable comparison to established strategies.
- This study provides a framework for selecting biomarkers to guide future preventative intervention trials.
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