Clinically significant novel biomarkers for prediction of first ever myocardial infarction: The Tromsø Study

• Published in: Circulation: Cardiovascular Genetics
• Main Authors: Wilsgaard, Tom, Mathiesen, Ellisiv Bøgeberg, Patwardhan, Anil, Rowe, Michael W., Schirmer, Henrik, Løchen, Maja-Lisa, Sudduth-Klinger, Julie, Hamren, Sarah, Bønaa, Kaare Harald, Njølstad, Inger
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: Lippincott Williams & Wilkins 2015
• Subjects: biomarker; cardiovascular disease; epidemiology; follow-up study; myocardial infarction; Norway; Tromsø
• Online Access: https://acuresearchbank.acu.edu.au/download/7247d1703445f33fb429d05fc14299d8e668c79579e962c70be636bdbee53d96/1850741/Wilsgaard_2015_Clinically_significant_novel_biomarkers_for_prediction.pdf; https://doi.org/10.1161/CIRCGENETICS.113.000630

Background: Identification of individuals with high risk for first-ever myocardial infarction ( MI ) can be improved. The objectives of the study were to survey multiple protein biomarkers for association with the 10-year risk of incident MI and identify a clinically significant risk model that adds information to current common risk models. Methods and Results: We used an immunoassay platform that uses a sensitive, sample-efficient molecular counting technology to measure 51 proteins in samples from the fourth survey ( 1994 ) in the Tromsø Study, a longitudinal study of men and women in Tromsø, Norway. A case control design was used with 419 first-ever MI cases ( 169 females/250 males ) and 398 controls ( 244 females/154 males ). Of the proteins measured, 17 were predictors of MI when considered individually after adjustment for traditional risk factors either in men, women, or both. The 6 biomarkers adjusted for traditional risk factors that were selected in a multivariable model ( odds ratios [OR] per standard deviation ) using a stepwise procedure were apolipoprotein B/apolipoprotein A1 ratio ( 1.40 ), kallikrein ( 0.73 ), lipoprotein a ( 1.29 ), matrix metalloproteinase 9 ( 1.30 ), the interaction term IP-10/CXCL10×women ( 0.69 ), and the interaction term thrombospondin 4×men ( 1.38 ). The composite risk of these biomarkers added significantly to the traditional risk factor model with a net reclassification improvement of 14% ( P=0.0002 ), whereas the receiver operating characteristic area increased from 0.757 to 0.791, P=0.0004. Conclusions: Novel protein biomarker models improve identification of 10-year MI risk above and beyond traditional risk factors with 14% better allocation to either high or low risk group.