Skip to main content
Erschienen in: Current Cardiovascular Risk Reports 2/2011

01.04.2011

Clinical Utility of Multiple Biomarker Panels for Cardiovascular Disease Risk Prediction

verfasst von: Maria Hughes, Frank Kee, Veikko Salomaa

Erschienen in: Current Cardiovascular Risk Reports | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

Current cardiovascular risk prediction is imprecise, with clinical treatment aimed at those with high risk of disease while neglecting those at intermediate risk who might benefit from early treatment. Biomarkers can capture features of subclinical atherosclerosis, but although many studies have shown their association with cardiovascular risk, whether they can improve the performance of prediction algorithms is contested. The combined use of multiple biomarkers offers promise for refining risk assessment by adding incremental information from different pathophysiologic pathways. The utility of certain combinations of multiple biomarkers has been shown to have greatest effect in selected patient subgroups (ie, middle-aged men and those at intermediate risk). Carefully designed randomized controlled trials are needed to understand the clinical implications of risk stratification using multiple biomarker panels.
Literatur
1.
Zurück zum Zitat Kathiresan S, Melander O, Anevski D et al.: Polymorphisms associated with cholesterol and risk of cardiovascular events. N Eng J Med 2008, 358:1240–1249.CrossRef Kathiresan S, Melander O, Anevski D et al.: Polymorphisms associated with cholesterol and risk of cardiovascular events. N Eng J Med 2008, 358:1240–1249.CrossRef
2.
Zurück zum Zitat Koenig W: Update on integrated biomarkers for assessment of long-term risk of cardiovascular complications in initially healthy subjects and patients with manifest atherosclerosis. Ann Med 2009, 41:332–343.PubMedCrossRef Koenig W: Update on integrated biomarkers for assessment of long-term risk of cardiovascular complications in initially healthy subjects and patients with manifest atherosclerosis. Ann Med 2009, 41:332–343.PubMedCrossRef
3.
Zurück zum Zitat Fryback DG, Thornbury JR: The efficacy of diagnostic imaging. Med Decis Making 1991, 11:88–94.PubMedCrossRef Fryback DG, Thornbury JR: The efficacy of diagnostic imaging. Med Decis Making 1991, 11:88–94.PubMedCrossRef
4.
Zurück zum Zitat Rothman K, Greenland S: Causation and causal inference in epidemiology. Am J Public Health 2005, 95:S144–S150.PubMedCrossRef Rothman K, Greenland S: Causation and causal inference in epidemiology. Am J Public Health 2005, 95:S144–S150.PubMedCrossRef
5.
Zurück zum Zitat Shaw LJ, Polk DM, Kahute TA, et al.: Prognostic accuracy of B natriuretic peptide measurements and coronary artery calcium in asymptomatic subjects (from the Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research [EISNER] study). Am J Cardiol 2009, 104:1245–1250.PubMedCrossRef Shaw LJ, Polk DM, Kahute TA, et al.: Prognostic accuracy of B natriuretic peptide measurements and coronary artery calcium in asymptomatic subjects (from the Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research [EISNER] study). Am J Cardiol 2009, 104:1245–1250.PubMedCrossRef
6.
Zurück zum Zitat Morrow DA, deLemos JA: Benchmarks for the assessment of novel cardiovascular biomarkers. Circulation 2007, 115:949–952.PubMedCrossRef Morrow DA, deLemos JA: Benchmarks for the assessment of novel cardiovascular biomarkers. Circulation 2007, 115:949–952.PubMedCrossRef
7.
Zurück zum Zitat •• Hlatky, MA, Greenland P, Arnett DK, et al.: Criteria for evaluation of novel markers of cardiovascular risk, A scientific statement from the American Heart Association. Circulation 2010, 119:2408–2416. This statement reviews current concepts of risk evaluation and proposes standards for the critical appraisal of risk assessment methods with a focus on assessing the clinical value of novel markers of CVD risk. CrossRef •• Hlatky, MA, Greenland P, Arnett DK, et al.: Criteria for evaluation of novel markers of cardiovascular risk, A scientific statement from the American Heart Association. Circulation 2010, 119:2408–2416. This statement reviews current concepts of risk evaluation and proposes standards for the critical appraisal of risk assessment methods with a focus on assessing the clinical value of novel markers of CVD risk. CrossRef
8.
Zurück zum Zitat Browne R, Whitcomb BW: Procedures for determination of detection limits: application to high performance liquid chromatography analysis of fat soluable vitamins in human serum. Epidemiology 2010, 21:S4–S9.PubMedCrossRef Browne R, Whitcomb BW: Procedures for determination of detection limits: application to high performance liquid chromatography analysis of fat soluable vitamins in human serum. Epidemiology 2010, 21:S4–S9.PubMedCrossRef
9.
Zurück zum Zitat Omland T, de Lemos JA, Sabatine MS, et al. : A sensitive cardiac Troponin T assay in stable coronary artery disease. N Engl J Med 2010, 361:26:2538–2546.CrossRef Omland T, de Lemos JA, Sabatine MS, et al. : A sensitive cardiac Troponin T assay in stable coronary artery disease. N Engl J Med 2010, 361:26:2538–2546.CrossRef
10.
Zurück zum Zitat Tibshirani R: The lasso method for variable selection in the cox model. Stat Med 1997, 16;385–395.PubMedCrossRef Tibshirani R: The lasso method for variable selection in the cox model. Stat Med 1997, 16;385–395.PubMedCrossRef
11.
Zurück zum Zitat Cook NR: Use and misuse of the receiever operating characteristic curve in risk prediction. Circulation 2007, 115:928–935.PubMedCrossRef Cook NR: Use and misuse of the receiever operating characteristic curve in risk prediction. Circulation 2007, 115:928–935.PubMedCrossRef
12.
Zurück zum Zitat Pencina M, D’Agostino RB Sr, D’Agostino RB Jr, Vasan RS: Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med 2008, 27:157–172.PubMedCrossRef Pencina M, D’Agostino RB Sr, D’Agostino RB Jr, Vasan RS: Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med 2008, 27:157–172.PubMedCrossRef
13.
Zurück zum Zitat Cook N, Ridker P: Advances in measuring the effect of individual predictors of cardiovascular risk: the role of reclassification measures. Ann Intern Med 2009, 150:795–802.PubMed Cook N, Ridker P: Advances in measuring the effect of individual predictors of cardiovascular risk: the role of reclassification measures. Ann Intern Med 2009, 150:795–802.PubMed
14.
Zurück zum Zitat Vickers AJ, Elkin EB: Decision curve analysis: a novel method for evaluating prediction models. Med Decis Making 2008, 28:453–473. Vickers AJ, Elkin EB: Decision curve analysis: a novel method for evaluating prediction models. Med Decis Making 2008, 28:453–473.
15.
Zurück zum Zitat Sattar N, Gaw A, Scherbakova O, et al.: Metabolic syndrome with and without C reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003, 108:414–419.PubMedCrossRef Sattar N, Gaw A, Scherbakova O, et al.: Metabolic syndrome with and without C reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003, 108:414–419.PubMedCrossRef
16.
Zurück zum Zitat Ridker PM, Buring JE, Cook NR, Rifai N: C–reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003, 107:391–397.PubMedCrossRef Ridker PM, Buring JE, Cook NR, Rifai N: C–reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy American women. Circulation 2003, 107:391–397.PubMedCrossRef
17.
Zurück zum Zitat Koenig W: Integrating biomarkers: The new frontier? Scand J Clin Lab Invest 2010, 70(Suppl 242):117–123.CrossRef Koenig W: Integrating biomarkers: The new frontier? Scand J Clin Lab Invest 2010, 70(Suppl 242):117–123.CrossRef
18.
Zurück zum Zitat Mora S, Rifai N, Buring JE, Ridker PM: Additive value of immunoassay-measured fibrinogen and high-sensitivity Creactive protein levels for predicting incident cardiovascular events. Circulation 2006, 114: 381–7.PubMedCrossRef Mora S, Rifai N, Buring JE, Ridker PM: Additive value of immunoassay-measured fibrinogen and high-sensitivity Creactive protein levels for predicting incident cardiovascular events. Circulation 2006, 114: 381–7.PubMedCrossRef
19.
Zurück zum Zitat Lowe GD, Sweetnam PM, Yarnell JW, et al.: C-reactive protein, fibrin D-dimer, and risk of ischemic heart disease: the Caerphilly and Speedwell studies. ATVB 2004, 24:1957–1962. Lowe GD, Sweetnam PM, Yarnell JW, et al.: C-reactive protein, fibrin D-dimer, and risk of ischemic heart disease: the Caerphilly and Speedwell studies. ATVB 2004, 24:1957–1962.
20.
Zurück zum Zitat Kiechl S, Willeit J, Mayr M, et al.: Oxidized phospholipids, lipoprotein(a), lipoprotein-associated phospholipase A2 activity, and 10-year cardiovascular outcomes: prospective results from the Bruneck study. ATVB 2007, 27:1788–1795. Kiechl S, Willeit J, Mayr M, et al.: Oxidized phospholipids, lipoprotein(a), lipoprotein-associated phospholipase A2 activity, and 10-year cardiovascular outcomes: prospective results from the Bruneck study. ATVB 2007, 27:1788–1795.
21.
Zurück zum Zitat Wang TJ, Gona P, Larson MG, et al.: Multiple biomarkers for the prediction of first major cardiovascular events and death. N Engl J Med 2006, 355(25):2631–2639.PubMedCrossRef Wang TJ, Gona P, Larson MG, et al.: Multiple biomarkers for the prediction of first major cardiovascular events and death. N Engl J Med 2006, 355(25):2631–2639.PubMedCrossRef
22.
Zurück zum Zitat • Zethelius B, Berglund L, Sundström J, et al.: Use of multiple biomarkers to improve the prediction of death from cardiovascular causes. N Engl J Med 2008, 358:20:2107–2116. This is one of the first articles to assess the clinical usefulness of a multiple biomarker score using newer metrics of clinical utility such as the NRI. PubMedCrossRef • Zethelius B, Berglund L, Sundström J, et al.: Use of multiple biomarkers to improve the prediction of death from cardiovascular causes. N Engl J Med 2008, 358:20:2107–2116. This is one of the first articles to assess the clinical usefulness of a multiple biomarker score using newer metrics of clinical utility such as the NRI. PubMedCrossRef
23.
Zurück zum Zitat Nambi V, Hoogeveen RC, Chambless L, et al.: Lipoprotein-associated phospholipase A2 and high sensitivity C-reactive protein improve the stratification of ischemic stroke risk in the atherosclerosis risk in communities (ARIC) study. Stroke 2009, 40:376–381.PubMedCrossRef Nambi V, Hoogeveen RC, Chambless L, et al.: Lipoprotein-associated phospholipase A2 and high sensitivity C-reactive protein improve the stratification of ischemic stroke risk in the atherosclerosis risk in communities (ARIC) study. Stroke 2009, 40:376–381.PubMedCrossRef
24.
Zurück zum Zitat Caslake M, Packard CJ, Robertson M, et al.: Lipoprotein-associated phospholipase A2, inflammatory biomarkers, and risk of cardiovascular disease in the Prospective Study of Pracastatin in the Elderly at Risk (PROSPER). Atherosclerosis 2010, 210:28–34.PubMedCrossRef Caslake M, Packard CJ, Robertson M, et al.: Lipoprotein-associated phospholipase A2, inflammatory biomarkers, and risk of cardiovascular disease in the Prospective Study of Pracastatin in the Elderly at Risk (PROSPER). Atherosclerosis 2010, 210:28–34.PubMedCrossRef
25.
Zurück zum Zitat Kizer JR, Krauser DG, Roseheffer RJ, et al.: Prognostic value of multiple biomarkers in American Indians free of clinically overt cardiovascular disease (from the Strong Heart Study). Am J Cardiol 2009, 104:247–253.PubMedCrossRef Kizer JR, Krauser DG, Roseheffer RJ, et al.: Prognostic value of multiple biomarkers in American Indians free of clinically overt cardiovascular disease (from the Strong Heart Study). Am J Cardiol 2009, 104:247–253.PubMedCrossRef
26.
Zurück zum Zitat • Kim HC, Greenland P, Rossouw JE, et al.: Multimarker prediction of coronary heart disease risk, the Women’s Health Initiative. J Am Coll Cardiol 2010, 55(19):2080–2091. This study assessed a multiple biomarker approach in a large sample of women enrolled in the Women’s Health Initiative hormone trials. Five of 18 biomarkers modestly improved discrimination (1.6%) compared with baseline models. PubMedCrossRef • Kim HC, Greenland P, Rossouw JE, et al.: Multimarker prediction of coronary heart disease risk, the Women’s Health Initiative. J Am Coll Cardiol 2010, 55(19):2080–2091. This study assessed a multiple biomarker approach in a large sample of women enrolled in the Women’s Health Initiative hormone trials. Five of 18 biomarkers modestly improved discrimination (1.6%) compared with baseline models. PubMedCrossRef
27.
Zurück zum Zitat Melander O, Newton-Cheh C, Almgren P, et al.: Novel and conventional biomarkers for the prediction of incident cardiovascular events in the community. JAMA 2009, 302:49–57.PubMedCrossRef Melander O, Newton-Cheh C, Almgren P, et al.: Novel and conventional biomarkers for the prediction of incident cardiovascular events in the community. JAMA 2009, 302:49–57.PubMedCrossRef
28.
Zurück zum Zitat Koenig W, Khuseyinova N, Lowel H, et al.: Lipoprotein-associated phospholipase A2 adds to risk prediction of incident coronary events by C-reactive protein in apparently healthy middle-aged men from the general population: results from the 14-year follow-up of a large cohort from southern Germany. Circulation 2004, 110:1903–1908.PubMedCrossRef Koenig W, Khuseyinova N, Lowel H, et al.: Lipoprotein-associated phospholipase A2 adds to risk prediction of incident coronary events by C-reactive protein in apparently healthy middle-aged men from the general population: results from the 14-year follow-up of a large cohort from southern Germany. Circulation 2004, 110:1903–1908.PubMedCrossRef
29.
Zurück zum Zitat Winkler K, Hoffmann MM, Winkelmann BR, et al.: Lipoprotein-associated phospholipase A2 predicts 5-year cardiac mortality independently of established risk factors and adds prognostic information in patients with low and medium high-sensitivity C-reactive protein (the Ludwigshafen Risk and Cardiovascular Health study). Clin Chem 2007, 53:1440–1447.PubMedCrossRef Winkler K, Hoffmann MM, Winkelmann BR, et al.: Lipoprotein-associated phospholipase A2 predicts 5-year cardiac mortality independently of established risk factors and adds prognostic information in patients with low and medium high-sensitivity C-reactive protein (the Ludwigshafen Risk and Cardiovascular Health study). Clin Chem 2007, 53:1440–1447.PubMedCrossRef
30.
Zurück zum Zitat •• Blankenberg S, Zeller T, Saarela O, et al.: Contribution of thirty biomarkers to ten-year cardiovascular risk prediction in two population cohorts. Circulation 2010, 121:2388–2397. These authors developed a multiple biomarker risk score from a large panel of biomarkers in the FINRISK97 cohort for the prediction of 10-year risk of CVD and externally validated this score in another European cohort of 2551 middle- aged European men. The score shows the potential for multiple biomarker panels to refine risk prediction in subpopulations at intermediate risk, such middle-aged men PubMedCrossRef •• Blankenberg S, Zeller T, Saarela O, et al.: Contribution of thirty biomarkers to ten-year cardiovascular risk prediction in two population cohorts. Circulation 2010, 121:2388–2397. These authors developed a multiple biomarker risk score from a large panel of biomarkers in the FINRISK97 cohort for the prediction of 10-year risk of CVD and externally validated this score in another European cohort of 2551 middle- aged European men. The score shows the potential for multiple biomarker panels to refine risk prediction in subpopulations at intermediate risk, such middle-aged men PubMedCrossRef
32.
Zurück zum Zitat Rubin DB: Multiple Imputation for Nonresponse in Surveys. John Wiley & Sons, New York; 1987.CrossRef Rubin DB: Multiple Imputation for Nonresponse in Surveys. John Wiley & Sons, New York; 1987.CrossRef
33.
Zurück zum Zitat He Y: Missing data analysis using multiple imputation, Getting to the heart of the matter. Circ Cardiovasc Qual Outcomes 2010, 3:98–105.PubMedCrossRef He Y: Missing data analysis using multiple imputation, Getting to the heart of the matter. Circ Cardiovasc Qual Outcomes 2010, 3:98–105.PubMedCrossRef
34.
Zurück zum Zitat Moons KGM, Donders RART, Stijnen T, Harrell FE: Using the outcome for imputation of missing predictor values was preferred. J Clin Epidemiol 2006, 59:1092–1101.PubMedCrossRef Moons KGM, Donders RART, Stijnen T, Harrell FE: Using the outcome for imputation of missing predictor values was preferred. J Clin Epidemiol 2006, 59:1092–1101.PubMedCrossRef
35.
Zurück zum Zitat Schnabel, RB, Schulz A, Messow CM, et al.: Multiple marker approach to risk stratification in patients with stable coronary artery disease. Eur Heart J 2010. doi:10.1093/eurhearj/ehq322. Schnabel, RB, Schulz A, Messow CM, et al.: Multiple marker approach to risk stratification in patients with stable coronary artery disease. Eur Heart J 2010. doi:10.​1093/​eurhearj/​ehq322.
36.
Zurück zum Zitat Dunlay SM, Gerber Y, Weston SA, et al.: Prognostic value of biomarkers in heart failure: application of novel methods in the community. Circ Heart Fail 2009, 2:393–400.PubMedCrossRef Dunlay SM, Gerber Y, Weston SA, et al.: Prognostic value of biomarkers in heart failure: application of novel methods in the community. Circ Heart Fail 2009, 2:393–400.PubMedCrossRef
37.
Zurück zum Zitat Nozaki T, Sugiyama S, Koga H, et al.: Significance of a multiple biomarker strategy including endothelial dysfunction to improve risk stratification for cardiovascular events in patients at high risk for coronary heart disease. J Am Coll Cardiol 2009, 54:600–608.CrossRef Nozaki T, Sugiyama S, Koga H, et al.: Significance of a multiple biomarker strategy including endothelial dysfunction to improve risk stratification for cardiovascular events in patients at high risk for coronary heart disease. J Am Coll Cardiol 2009, 54:600–608.CrossRef
38.
Zurück zum Zitat Elliott P, Chambers JC, Zhang W, et al.: Genetic loci associated with C-reactive protein levels and risk of coronary heart disease. JAMA 2009, 302:37–48.PubMedCrossRef Elliott P, Chambers JC, Zhang W, et al.: Genetic loci associated with C-reactive protein levels and risk of coronary heart disease. JAMA 2009, 302:37–48.PubMedCrossRef
39.
Zurück zum Zitat The Emerging Risk Factors Collaboration: C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet 2010, 375:132–140.CrossRef The Emerging Risk Factors Collaboration: C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet 2010, 375:132–140.CrossRef
40.
Zurück zum Zitat Ridker PM, Danielson E, Fonseca FAH, et al.: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 2008, 59:2195–2207.CrossRef Ridker PM, Danielson E, Fonseca FAH, et al.: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 2008, 59:2195–2207.CrossRef
41.
Zurück zum Zitat National Institute for Health and Clinical Excellence (NICE): Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease, Costing report. , Available at http://www.nice.ord.uk/CG067. Accessed May 2008. National Institute for Health and Clinical Excellence (NICE): Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease, Costing report. , Available at http://​www.​nice.​ord.​uk/​CG067. Accessed May 2008.
42.
Zurück zum Zitat Sheridan SL, Viera AJ, Krantz MJ, et al.: The effect of giving global coronary risk information to adults. Arch Int Med 2010, 170:230–239.CrossRef Sheridan SL, Viera AJ, Krantz MJ, et al.: The effect of giving global coronary risk information to adults. Arch Int Med 2010, 170:230–239.CrossRef
43.
Zurück zum Zitat Glasziou PP, Irwig L, Heritier S, Simes RJ, Tonkin A for the LIPID study investigators: Monitoring cholesterol levels: measurement error or true change? Ann Inter Med 2008, 148:656–661. Glasziou PP, Irwig L, Heritier S, Simes RJ, Tonkin A for the LIPID study investigators: Monitoring cholesterol levels: measurement error or true change? Ann Inter Med 2008, 148:656–661.
44.
Zurück zum Zitat Eagle, KA, Ginsburg GS, Musunuru K, et al.: Identifying patients at high risk of a cardiovascular event in the near future. Current status and future directions: Report of a National Heart, Lung and Blood Institute Working Group. Circulation 2010, 121:1447–1454.PubMedCrossRef Eagle, KA, Ginsburg GS, Musunuru K, et al.: Identifying patients at high risk of a cardiovascular event in the near future. Current status and future directions: Report of a National Heart, Lung and Blood Institute Working Group. Circulation 2010, 121:1447–1454.PubMedCrossRef
45.
Zurück zum Zitat • Schnell-Inderst P, Schwarzer R, Gohler A, et al.: Prognostic value, clinical effectiveness, and cost-effectiveness of high sensitivity C-reactive protein as a marker for major cardiac events in asymptomatic individuals: A health technology assessment report. Int J Tech Ass Health Care 2010, 26:30–39. This study assessed the net effect of hsCRP screening strategy on clinical outcomes, underlined the importance of assessing the direct and indirect effects of a biomarker test on patient outcomes. CrossRef • Schnell-Inderst P, Schwarzer R, Gohler A, et al.: Prognostic value, clinical effectiveness, and cost-effectiveness of high sensitivity C-reactive protein as a marker for major cardiac events in asymptomatic individuals: A health technology assessment report. Int J Tech Ass Health Care 2010, 26:30–39. This study assessed the net effect of hsCRP screening strategy on clinical outcomes, underlined the importance of assessing the direct and indirect effects of a biomarker test on patient outcomes. CrossRef
46.
Zurück zum Zitat Henriksson, M, Palmer S, Chen R, et al.: Assessing the cost effectiveness of using prognostic biomarkers with decision models: case study in prioritising patients waiting for coronary artery surgery. BMJ 2010, 340:b5606.PubMedCrossRef Henriksson, M, Palmer S, Chen R, et al.: Assessing the cost effectiveness of using prognostic biomarkers with decision models: case study in prioritising patients waiting for coronary artery surgery. BMJ 2010, 340:b5606.PubMedCrossRef
47.
Zurück zum Zitat Genders TSS, Meijboom WB, Meijs MF, et al.: CT coronary angiography in patients suspected of having coronary artery disease: decision making from various perspectives in the face of uncertainty. Radiology 2009, 253:734–744.PubMedCrossRef Genders TSS, Meijboom WB, Meijs MF, et al.: CT coronary angiography in patients suspected of having coronary artery disease: decision making from various perspectives in the face of uncertainty. Radiology 2009, 253:734–744.PubMedCrossRef
Metadaten
Titel
Clinical Utility of Multiple Biomarker Panels for Cardiovascular Disease Risk Prediction
verfasst von
Maria Hughes
Frank Kee
Veikko Salomaa
Publikationsdatum
01.04.2011
Verlag
Current Science Inc.
Erschienen in
Current Cardiovascular Risk Reports / Ausgabe 2/2011
Print ISSN: 1932-9520
Elektronische ISSN: 1932-9563
DOI
https://doi.org/10.1007/s12170-010-0153-1

Weitere Artikel der Ausgabe 2/2011

Current Cardiovascular Risk Reports 2/2011 Zur Ausgabe

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.