ArticleClinical research in cardiology : official journal of the German Cardiac Society2024
Prognostic utility of a multi-biomarker panel in patients with suspected myocardial infarction.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 6 citations in OpenAlex.
- Circulating multiple metals and mortality after myocardial infarction: incremental value beyond GRACE.American journal of preventive cardiology · 2026Article
- Early Peri-Admission Lactate-to-Albumin (LAR), C-Reactive Protein-to-Albumin (CAR), and Procalcitonin-to-Albumin (PAR) Ratios and ICU Mortality in a Tertiary Cardiac ICU.Journal of clinical medicine · 2026Article
- Effects of sacubitril/valsartan combined with ivabradine in treating cardiorenal syndrome.American journal of translational research · 2026Article
- The Level of Apolipoprotein A-I Is Associated with a Prognosis in Patients with Chronic Heart Failure Especially in HFmrEF and HFpEF: A Retrospective Cohort Study.International journal of general medicine · 2025Article
- Physiological-immune resilience risk assessment model for predicting adverse cardiac outcomes in patients with acute myocardial infarction.Frontiers in cardiovascular medicine · 2025Article
- Troponin Test, Not Only a Number: An Unusual Case of False Positive.International journal of molecular sciences · 2024Article
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Authors and funding
13 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe accurate identification of patients with high cardiovascular risk in suspected myocardial infarction (MI) is an unmet clinical need. Therefore, we sought to investigate the prognostic utility of a multi-biomarker panel with 29 different biomarkers in in 748 consecutive patients with symptoms indicative of MI using a machine learning-based approach.
methodsIncident major cardiovascular events (MACE) were documented within 1 year after the index admission. The selection of the best multi-biomarker model was performed using the least absolute shrinkage and selection operator (LASSO). The independent and additive utility of selected biomarkers was compared to a clinical reference model and the Global Registry of Acute Coronary Events (GRACE) Score, respectively. Findings were validated using internal cross-validation.
resultsMedian age of the study population was 64 years. At 1 year of follow-up, 160 cases of incident MACE were documented. 16 of the investigated 29 biomarkers were significantly associated with 1-year MACE. Three biomarkers including NT-proBNP (HR per SD 1.24), Apolipoprotein A-I (Apo A-I; HR per SD 0.98) and kidney injury molecule-1 (KIM-1; HR per SD 1.06) were identified as independent predictors of 1-year MACE. Although the discriminative ability of the selected multi-biomarker model was rather moderate, the addition of these biomarkers to the clinical reference model and the GRACE score improved model performances markedly (∆C-index 0.047 and 0.04, respectively).
conclusionNT-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.
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