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Biomarkers Ability to Predict Heart Disease and Stroke is Limited

sk, along with the usual history, physical examination and other assessments taken as part of the overall Offspring Study. Those known to have a prior heart attack or stroke were excluded from the biomarker study.

Among the 3,200 participants in the biomarker study, 169 experienced a major cardiovascular event – such as heart attack, stroke or cardiac death – during the study period of up to 10 years. The biomarkers that proved most useful in predicting future cardiovascular events were BNP and urinary albumin content. BNP appeared to be a stronger predictor of risk than C-reactive protein, possibly the best-known cardiovascular biomarker. However, even though those with high multimarker scores had twice the risk of a cardiovascular event as those with low scores, the information provided by the biomarkers only slightly improved predictions based on such conventional risk factors as hypertension, cholesterol levels and smoking.

"There has been a great deal of enthusiasm among cardiologists over the potential of biomarkers, but our findings suggest that we need to identify additional biomarkers to be able to predict individual risk in a useful fashion," says Wang. "Newer biological approaches, such as genomics and proteomics, may give us tools that can help identify these new biomarkers." Wang is an assistant professor of Medicine at Harvard Medical School.

"This important study shows that conventional risk factors have stood the test of time and are still good predictors of risk, while at the same time adding to the growing body of information on novel biomarkers," says Elizabeth G. Nabel, MD, director of the National Heart, Lung and Blood Institute (NHLBI), which sponsors the Framingham Heart Study. "Although there was only a modest improvement in risk assessment when new risk factors were added to conventional ones, it was enough to show the potential value of the newer markers. We look to further research to identify other b
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