Prognostic utility of a multi-biomarker panel in patients with suspected myocardial infarction.
Betül ToprakJessica WeimannJonas LehmacherPaul M HallerTau S HartikainenAlina SchockMahir KarakasThomas RennéTanja ZellerRaphael TwerenboldNils A SörensenDirk WestermannJohannes T NeumannPublished in: Clinical research in cardiology : official journal of the German Cardiac Society (2023)
NT-proBNP, Apo A-I and KIM-1 emerged as strongest independent predictors of 1-year MACE in patients with suspected MI. Their integration into clinical risk prediction models may improve personalized risk stratification. Prognostic utility of a multi-biomarker approach in suspected myocardial infarction. In a cohort of 748 patients with symptoms indicative of myocardial infarction (MI) to the emergency department, we measured a 29-biomarker panel and performed regressions, machine learning (ML)-based variable selection and discriminative/reclassification analyses. We identified three biomarkers as top predictors for 1-year major adverse cardiovascular events (MACE). Their integration into a clinical risk prediction model and the Global Registry of Acute Coronary Events (GRACE) Score allowed for marked improvement in discrimination and reclassification for 1-year MACE. Apo apolipoprotein; CRP C-reactive protein; CRS clinical risk score; ECG electrocardiogram; EN-RAGE extracellular newly identified receptor for advanced glycation end-products binding protein; FABP fatty acid-binding protein; GS Grace Score; hs-cTnI high-sensitivity cardiac troponin I; KIM-1 kidney injury molecule-1; LASSO least absolute shrinkage and selection operator; MACE major adverse cardiovascular events; MI myocardial infarction; NRI net reclassification improvement; NT-proBNP N-terminal prohormone of brain natriuretic peptide.
Keyphrases
- cardiovascular events
- binding protein
- coronary artery disease
- emergency department
- heart failure
- machine learning
- left ventricular
- cardiovascular disease
- fatty acid
- type diabetes
- liver failure
- pulmonary embolism
- coronary artery
- heart rate variability
- intensive care unit
- big data
- physical activity
- depressive symptoms
- artificial intelligence
- respiratory failure
- extracorporeal membrane oxygenation
- resting state
- blood brain barrier
- functional connectivity
- aortic stenosis
- ejection fraction