Mazandaran Association of Emergency Medicine Translational Health Reports 3092-6750 1 1 2025 09 13 Integrated Use of Cardiac and Vascular Biomarkers ,in Forecasting Major Cardiovascular Outcomes 1 10 229211 10.22034/thr.2025.229211 EN Saaedeh Chalaki Emergency Medicine Specialist Iraj Goli Khatir Emergency Medicine Specialist 0000-0002-4708-7874 Banafsheh Noori GharnSaraei Cardiology Specialist Journal Article 2025 09 13 This forward-looking clinical investigation explored the prognostic utility of four distinct <br />biomarkers—high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro b-type <br />natriuretic peptide (NT-proBNP), Copeptin, and Mid-regional pro-Adrenomedullin (MR<br />proADM)—in forecasting significant cardiovascular complications among 120 individuals <br />presenting with symptoms suggestive of acute coronary syndrome (ACS) in an emergency <br />care setting. Across a 12-month observation window, occurrences of major adverse <br />cardiovascular events (MACE)—encompassing myocardial infarction, stroke, and <br />cardiovascular mortality—were systematically tracked and correlated with both initial and <br />serial biomarker measurements. <br />Multivariate analysis using Cox proportional hazards modeling, adjusted for demographic <br />and behavioral risk factors such as age, sex, and smoking, revealed a robust association <br />between elevated biomarker levels and MACE incidence. Diagnostic accuracy for each <br />marker—individually and collectively—was assessed through ROC curve analysis, <br />demonstrating favorable area under the curve (AUC) values indicative of strong predictive <br />performance. Survival outcomes stratified by median biomarker thresholds were estimated <br />using Kaplan-Meier methodology, showing pronounced differences in MACE-free survival <br />between high- and low-risk groups. <br />The findings affirm the clinical value of hs-cTnT, NT-proBNP, Copeptin, and MR-proADM in <br />early cardiovascular risk stratification. Moreover, the integrative use of these markers was <br />shown to outperform any single biomarker alone, emphasizing their combined role in <br />refining diagnostic precision and guiding therapeutic decisions. These results support <br />incorporating such biomarker panels into routine evaluation protocols for patients <br />undergoing assessment for suspected ACS. https://www.threports.com/article_229211_fcdc5c4452ef837eb2e350b061f47b26.pdf