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- W2048864018 abstract "This editorial refers to ‘Multiple marker approach to risk stratification in patients with stable coronary artery disease’[†][1], by R.B. Schnabel et al. , on page 3024 Individual biomarkers have expanding roles in risk assessment, diagnosis, and prognosis, and the list of up-and-coming markers is growing. Nonetheless, individual biomarkers have notable shortcomings, including day-to-day intra-individual variation and poor predictive values at the level of the individual patient, which limit their prognostic value. Combining multiple biomarkers from distinct pathophysiological pathways has the potential to overcome many of these pitfalls and to further improve risk stratification, and there has been a natural evolution towards studies evaluating such a multimarker approach. However, to date, a mixed picture has emerged on the clinical value of using multiple biomarkers for cardiovascular risk stratification.A number of studies have evaluated combinations of biomarkers for predicting cardiovascular disease in the community. Several have found statistically significant yet clinically modest improvements in prediction with a multimarker panel compared with a model with traditional risk factors alone.1–3 A few, however, have found substantial improvements in risk prediction with a multimarker approach.4–6Secondary prevention populations have been the focus of even fewer studies evaluating a multimarker risk stratification approach. Blankenberg et al. 7 studied 11 biomarkers [including nine inflammatory markers plus N-terminal pro-B-type natriuretic peptide (Nt-proBNP), and microalbuminuria] in 3199 patients with a history of coronary heart disease, peripheral vascular disease, diabetes, or stroke. After a mean 4.5 year follow-up, only Nt-proBNP provided incremental prognostic information for prediction of cardiovascular events compared with a traditional risk factor model, based on an increase in the area under the receiver-operating characteristic curve, or c-statistic. Although several inflammatory markers were significantly related to future cardiovascular risk, they added little additional prognostic information to the traditional markers. … [1]: #fn-2" @default.
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- W2048864018 date "2010-09-23" @default.
- W2048864018 modified "2023-10-16" @default.
- W2048864018 title "Multiple marker approach to risk stratification in patients with stable coronary artery disease: to have or have not" @default.
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- W2048864018 doi "https://doi.org/10.1093/eurheartj/ehq336" @default.
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