Adding traditional and emerging biomarkers for risk assessment in secondary prevention: A prospective cohort study of 20,656 patients with cardiovascular disease

• Published in: European journal of preventive cardiology 2024-10
• Main Authors: Rochmawati, Ike Dhiah, Deo, Salil, Lees, Jennifer S, Mark, Patrick B, Sattar, Naveed, Celis-Morales, Carlos, Pell, Jill P, Welsh, Paul, Ho, Frederick K
• Format: Article
• Language: English
• ISSN: 2047-4873; 2047-4881; 2047-4881
• DOI: 10.1093/eurjpc/zwae352

This study aims to explore whether conventional and emerging biomarkers could improve risk discrimination and calibration in secondary prevention of recurrent atherosclerotic cardiovascular disease (ASCVD), based on a model using predictors from SMART2. In a cohort of 20,658 UK Biobank participants with medical history of ASCVD, we analysed any improvement in C indices and net reclassification index (NRI) for future ASCVD events, following addition of LP-a, ApoB, cystatin C, HbA1c, GGT, AST, ALT, and ALP, to a model with predictors used in SMART2 for the outcome of recurrent major cardiovascular event. We also examined any improvement in C indices and NRIs replacing creatinine based estimated glomerular filtration rate (eGFR) with cystatin C based estimates. Calibration plots between different models were also compared. Compared with the baseline model (C index=0.663), modest increment in C indices were observed when adding HbA1c (ΔC=0.0064, p