1. Multimarker Approach to Identify Patients with Coronary Artery Disease at High Risk for Subsequent Cardiac Adverse Events: The Multi-Biomarker Study
- Author
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Alfred Gugerell, Noemi Pavo, Georgiana-Aura Giurgea, Katrin Zlabinger, Claudia Müller, Dominika Lukovic, Denise Traxler-Weidenauer, Ljubica Mandic, Andreas Spannbauer, Anahit Anvari, Nina Kastner, Jutta Bergler-Klein, Bonni Syeda, Mariann Gyöngyösi, and Julia Mester-Tonczar
- Subjects
Male ,medicine.medical_specialty ,Myocardial Infarction ,lcsh:QR1-502 ,adverse event ,Comorbidity ,030204 cardiovascular system & hematology ,Logistic regression ,Risk Assessment ,Biochemistry ,Article ,lcsh:Microbiology ,Cohort Studies ,Coronary artery disease ,03 medical and health sciences ,risk prediction ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Copeptin ,Discriminant function analysis ,Risk Factors ,Internal medicine ,multimarker approach ,C-statistics ,Clinical endpoint ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,Molecular Biology ,Aged ,Aged, 80 and over ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Death ,Hospitalization ,Stroke ,canonical discriminant analysis ,SuPAR ,Cardiology ,Biomarker (medicine) ,Female ,business ,Biomarkers ,coronary artery disease - Abstract
In our prospective non-randomized, single-center cohort study (n = 161), we have evaluated a multimarker approach including S100 calcium binding protein A12 (S100A1), interleukin 1 like-receptor-4 (IL1R4), adrenomedullin, copeptin, neutrophil gelatinase-associated lipocalin (NGAL), soluble urokinase plasminogen activator receptor (suPAR), and ischemia modified albumin (IMA) in prediction of subsequent cardiac adverse events (AE) during 1-year follow-up in patients with coronary artery disease. The primary endpoint was to assess the combined discriminatory predictive value of the selected 7 biomarkers in prediction of AE (myocardial infarction, coronary revascularization, death, stroke, and hospitalization) by canonical discriminant function analysis. The main secondary endpoints were the levels of the 7 biomarkers in the groups with/without AE, comparison of the calculated discriminant score of the biomarkers with traditional logistic regression and C-statistics. The canonical correlation coefficient was 0.642, with a Wilk&rsquo, s lambda value of 0.78 and p <, 0.001. By using the calculated discriminant equation with the weighted mean discriminant score (centroid), the sensitivity and specificity of our model were 79.4% and 74.3% in prediction of AE. These values were higher than that of the calculated C-statistics if traditional risk factors with/without biomarkers were used for AE prediction. In conclusion, canonical discriminant analysis of the multimarker approach is able to define the risk threshold at the individual patient level for personalized medicine.
- Published
- 2020
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