Abstract 16749: BioImage Study: Value of Novel Biomarker Panel (CardioSCORE) in Predicting Major Adverse Cardiovascular Events among those with Absence of Coronary Artery Calcification

Abstract

Background: Asymptomatic persons with absent coronary artery calcium (CAC) are at very low risk of future cardiovascular events with little value of measuring traditional biomarkers for risk assessment. In this study we aim to assess whether a multi-marker panel of 7 proteins (CardioSCORE) can provide prognostic information for predicting major adverse cardiovascular events (MACE) among those with CAC=0.

Methods: The study population is derived from the prospective BioImage Study designed to evaluate associations among imaging and circulating biomarkers and their ability to predict atherothrombotic events in asymptomatic at-risk subjects aged 55 years and above. The CardioSCORE panel had been discovered and developed from myocardial infarction case-cohort studies as part of the General population Study and is presented as a single numerical score based on the levels of Apolipoprotein A1, Apolipoprotein B, beta-2 microglobulin, carcinoembryonic antigen, high sensitivity C-reactive protein, lipoprotein(a), and transferrin.

Results: The study population consisted 1,789 individuals with CAC=0 at baseline (67±6 years, 29% males). The median (IQR) CardioSCORE was 4.4 (3.5-5.4). In a median follow-up of 2.4 years, 43 (2.3%) MACE was noted. Overall 1.88% events were noted in those with CardioSCORE in the first quartile, whereas 1.06%, 2.86% and 3.76% MACE were noted in those with 2^nd-4^thquartiles of CardioSCORE (p=0.04 for trend), respectively. In multivariate adjusted analysis, 1 SD increase in CardioSCORE (1.4) was associated 1.53( 95% CI: 1.08-2.18) higher fold risk for MACE. In comparison none of the traditional risk factors as well as IMT was associated with increased risk for MACE among those with CAC=0.

Conclusion: These data demonstrate that a composite aggregate derived from the 7-biomarker CardioSCORE profile may provide near-term prognostic information among those with absence of CAC.