Cited by 63Lipoproteins and Cardiovascular HealthCardiovascular Health and Risk FactorsHealth Promotion and Cardiovascular Prevention

A systematic review and meta-analysis of advanced biomarkers for predicting incident cardiovascular disease among asymptomatic middle-aged adults

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Romero-Cabrera, Juan Luis, Ankeny, Jacob, Fernández-Montero, Alejandro, Kales, Stefanos N., Smith, Denise L.·2022·International Journal of Molecular Sciences

Abstract

Cardiovascular disease (CVD) continues as the most important cause of mortality. Better risk screening and prediction are needed to reduce the cardiovascular disease burden. The aim of the study was to assess the role of serum biomarkers in the prediction of CVD among asymptomatic middle-aged adults with no prior CVD history. A systematic review and meta-analysis were carried out using literature from PubMed and following PRISMA reporting guidelines. Twenty-five studies met our inclusion criteria and were included in the systematic review. The most commonly studied biomarker was high-sensitivity C reactive protein (hs-CRP) (10 studies), which showed that higher hs-CRP levels are associated with an increased risk of subsequent CVD events and mortality. In addition, several less-studied biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP), fibrinogen, gamma-glutamyl transferase (GGT), and others) also showed significant associations with greater future risk of CVD. A meta-analysis was possible to perform for hs-CRP and NT-proBNP, which showed statistically significant results for the ability of hs-CRP (hazard ratio (HR) 1.19, (95% CI: 1.09−1.30), p < 0.05) and NT-proBNP (HR 1.22, (1.13−1.32), p < 0.05) to predict incident CVD among middle-aged adults without a prior CVD history or symptoms. Several serum biomarkers, particularly hs-CRP and NT-proBNP, have the potential to improve primary CVD risk prevention among asymptomatic middle-aged adults.

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Crossref · 10.3390/ijms232113540

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  • CRP is often used as a metabolic risk marker and is associated with an increased risk of cardiovascular disease.

    “CRP is often used as a metabolic risk marker and is associated with an increased risk of cardiovascular disease (82).”

    From Metformin and Combined Oral Contraceptive Pills in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis (2024) · cites this paper as [82]

    The Results report that higher hs-CRP was associated with greater cardiovascular disease risk among asymptomatic middle-aged adults. The Discussion describes hs-CRP as a marker of inflammation used in cardiovascular risk assessment, but does not establish that CRP is often used as a metabolic risk marker. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Authors
Romero-Cabrera, J. L., Ankeny, J., Fernández-Montero, A., Kales, S. N., & Smith, D. L.
Affiliations
  • Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain
  • Harvard University (US)
  • Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
  • Cambridge Health Alliance (US)
  • Skidmore College (US)
Corresponding author
Smith, Denise L.
Venue
International Journal of Molecular Sciences
Publisher
MDPI AG
Published
2022-11-04
Volume
23
Issue
21
Pages
13540
ISSN
1422-0067 (ISSN-L)
OpenAlex
W4308509933
Cited by
63
References
62
Citations by year
2026: 9 · 2025: 26 · 2024: 15 · 2023: 13
FWCI
3.21
Type
journal article
Language
en
Open access
Locations
  • International Journal of Molecular Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Federal Emergency Management Agency (EMW-FP-PP-00445)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
cardiovascular disease, serum biomarkers, high-sensitivity C-reactive protein, NT-proBNP, fibrinogen, gamma-glutamyl transferase, cardiovascular risk screening, primary prevention, cardiovascular mortality
MeSH terms
Adult, C-Reactive Protein, Cardiovascular Diseases, Humans, Middle Aged, Peptide Fragments, Risk Factors, Biomarkers, Proportional Hazards Models, Natriuretic Peptide, Brain

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