 | | Multiple Biomarker Panels for Cardiovascular Risk Assessment |
|  | | Multiple Biomarker Panels for Cardiovascular Risk Assessment |
|
 | | Massachusetts, USA |
|  | | Massachusetts, USA |
|
 | | Concept of cardiovascular “risk factors” |
|  | | Not all individuals with coronary heart disease have traditional risk factors |
|
 | | CRP and cardiovascular risk in apparently healthy men |
|  | | CRP: epidemiologic studies |
|
 | | Recommending wider use of CRP |
|  | | CRP: reappraisal |
|
 | | What is the magnitude of association? |
|  | | The number of candidate cardiovascular biomarkers has increased |
|
 | | There are other biomarkers: example |
|  | | BNP levels and Events over 5-year follow-up |
|
 | | Risks associated with elevated BNP levels |
|  | | “Multimarker” approach |
|
 | | Testing the multimarker approach: the Framingham Heart Study experience |
|  | | “Multimarker” approach |
|
 | | Markers Selected by Backward Elimination |
|  | | Multiple biomarkers and ROC curves for CVD prediction |
|
 | | Multiple markers and c-statistics in Framingham |
|  | | C-statistics (discrimination) versus relative risk |
|
 | | Criticisms of the c-statistic and alternatives |
|  | | Reclassification: focus on specific cutpoints |
|
 | | Reclassification to change therapy for primary prevention |
|  | | Reclassification matrix |
|
 | | Measuring reclassification |
|  | | Slide 28 |
|
 | | Biomarkers for risk prediction in Malmo cohort: relative risks |
|  | | Reclassification matrix |
|
 | | Reclassification matrix: cases only |
|  | | Reclassification matrix: Non-cases |
|
 | | Reclassification in Malmo cohort |
|  | | Reclassification matrix: intermediate-risk only |
|
 | | Reclassification matrix: cases only |
|  | | Reclassification matrix: Non-cases |
|
 | | Reclassification in the intermediate-risk group |
|  | | What about the JUPITER trial? |
|
 | | JUPITER trial |
|  | | JUPITER trial myths |
|
 | | Mendelian randomization data show no relation between CRP-altering SNPs and CV disease |
|  | | JUPITER trial myths |
|
 | | JUPITER trial myths |
|  | | Implications of JUPITER (1) |
|
 | | Implications of JUPITER (2) |
|  | | Clinical approaches |
|
 | | CRP and re-classification using the Reynolds risk score |
|  | | What is the future of biomarkers for CV risk prediction? |
|
 | | What is the gain from searching for more biomarkers? |
|  | | Most current biomarkers correlate with each other |
|
 | | The search for novel biomarkers |
|  | | Proteomics and metabolomics |
|
 | | Example: metabolomics and CAD |
|  | | Example: metabolomics and CAD |
|
 | | Example: metabolomics and CAD |
|  | | Future directions |
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