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Markers of Myocardial Stress, Myocardial Injury, and Subclinical Inflammation and the Risk of Sudden Death
Brendan M Everett1,2, M V Moorthy1, Jani T Tikkanen1
1Divisions of Preventive Medicine (B.M.E., M.V.M., J.T.T., N.R.C., C.M.A.), Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Circulation
|July 24, 2020
Summary
Sudden cardiac death (SCD) risk can be identified using common biomarkers like cholesterol ratios, troponin I, NT-proBNP, and CRP. Combining these markers effectively predicts elevated SCD risk, even in seemingly low-risk individuals.
Area of Science:
- Cardiology
- Biomarkers
- Preventive Medicine
Background:
- Sudden cardiac death (SCD) often occurs first in individuals without diagnosed cardiovascular disease (CVD).
- Biomarkers can detect subclinical CVD and identify individuals at higher risk for SCD.
Purpose of the Study:
- To evaluate if specific biomarkers (lipid ratio, hs-cTnI, NT-proBNP, hs-CRP) predict SCD risk.
- To assess the combined predictive power of these biomarkers in diverse populations.
Main Methods:
- A nested case-control study analyzed 6 prospective cohorts.
- 565 SCD cases were matched with 1090 controls based on age, sex, ethnicity, smoking, and CVD status.
- Follow-up averaged 11.3 years.
Main Results:
- Each biomarker (lipid ratio, hs-cTnI, NT-proBNP, hs-CRP) independently predicted SCD risk.
- Higher levels of these biomarkers were associated with significantly increased odds of SCD.
- A composite biomarker score demonstrated a strong association with SCD risk.
Conclusions:
- Lipid profiles, cardiac troponin I, NT-proBNP, and C-reactive protein are significant independent predictors of SCD.
- These widely available measures can help identify individuals at risk for SCD.
- Combining these biomarkers may improve risk stratification for sudden cardiac death.
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