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Lipid-based score improves CVD risk prediction in patients with CAD
A diagnostic test based on ceramide lipids and phospholipids improved prediction of risk for CVD events among patients with CAD, according to findings published in the European Heart Journal.
The test, which analyzes ceramides and phosphatidylcholines using liquid chromatography-mass spectrometry, enabled the researchers to develop a risk score (CERT2, Zora Biosciences Oy) that was developed in 3,789 patients with CAD from the WECAC cohort and validated in 5,991 patients with CAD from the LIPID cohort and 1,023 patients with CAD from the KAROLA cohort.
The score consists of one ceramide/ceramide ratio, two ceramide/phosphatidylcholine ratios and a single phosphatidylcholine, Mika Hilvo, PhD, head of bioinformatics at Zora Biosciences Oy, and colleagues wrote.
The score significantly predicted CVD events in the WECAC (adjusted HR per standard deviation [SD] = 1.44; 95% CI, 1.28-1.63), LIPID (aHR per SD = 1.47; 95% CI, 1.34-1.61) and KAROLA (aHR per SD = 1.69; 95% CI, 1.31-2.17) cohorts, the researchers wrote.
Combining the score with high-sensitivity troponin T further improved CVD event prediction in the WECAC (aHR per SD = 1.63; 95% CI, 1.44-1.85) and KAROLA (aHR per SD = 2.04; 95% CI, 1.57-2.64) cohorts, according to the researchers.
When the risk score was combined with age and sex in the WECAC cohort, the C-statistic was 0.76 for CVD death, Hilvo and colleagues wrote.
Adding CERT2 to other scores developed from WECAC improved the C-statistic and net reclassification index, and CERT2 improved C-statistics when added to conventional risk factors and biomarkers in all three cohorts, according to the researchers.
The score “offers an easy-to-use tool for residual risk estimation in CHD,” Hilvo and colleagues wrote. “This validated risk stratification tool may be used to further improve development of personalized management of CHD, which should be tested in future prospective studies.” – by Erik Swain
Disclosures: Hilvo is an employee of Zora Biosciences Oy. Please see the study for all other authors’ relevant financial disclosures.