Integrated Use of Cardiac and Vascular Biomarkers ,in Forecasting Major Cardiovascular Outcomes
Pages 1-10
https://doi.org/10.22034/thr.2025.229211
Saaedeh Chalaki, Iraj Goli Khatir, Banafsheh Noori GharnSaraei
Abstract This forward-looking clinical investigation explored the prognostic utility of four distinct
biomarkers—high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro b-type
natriuretic peptide (NT-proBNP), Copeptin, and Mid-regional pro-Adrenomedullin (MR
proADM)—in forecasting significant cardiovascular complications among 120 individuals
presenting with symptoms suggestive of acute coronary syndrome (ACS) in an emergency
care setting. Across a 12-month observation window, occurrences of major adverse
cardiovascular events (MACE)—encompassing myocardial infarction, stroke, and
cardiovascular mortality—were systematically tracked and correlated with both initial and
serial biomarker measurements.
Multivariate analysis using Cox proportional hazards modeling, adjusted for demographic
and behavioral risk factors such as age, sex, and smoking, revealed a robust association
between elevated biomarker levels and MACE incidence. Diagnostic accuracy for each
marker—individually and collectively—was assessed through ROC curve analysis,
demonstrating favorable area under the curve (AUC) values indicative of strong predictive
performance. Survival outcomes stratified by median biomarker thresholds were estimated
using Kaplan-Meier methodology, showing pronounced differences in MACE-free survival
between high- and low-risk groups.
The findings affirm the clinical value of hs-cTnT, NT-proBNP, Copeptin, and MR-proADM in
early cardiovascular risk stratification. Moreover, the integrative use of these markers was
shown to outperform any single biomarker alone, emphasizing their combined role in
refining diagnostic precision and guiding therapeutic decisions. These results support
incorporating such biomarker panels into routine evaluation protocols for patients
undergoing assessment for suspected ACS.