Cardiac biomarkers in patients with ischemic heart disease enrolled in a cardiac rehabilitation program

BACKGROUND: Several plasma lipid and non-lipid biomarkers have been shown to predict major cardiovascular events in population studies, but data on novel biomarkers in secondary prevention are sparse and there exists marked heterogeneity across trials. OBJECTIVE: Aim of our study was to determine whether temporary changes of traditional lipid and new lipid and non-lipid biomarkers like UACR, hs-CRP, Nt-proBNP, Lp(a), ApoA and ApoB, observed during a Secondary Prevention and Cardiac Rehabilitation Program (SPCRP), are associated to CV risk (primary combined end-point of cardiovascular mortality and re-hospitalization). MATERIALS AND METHODS: we enrolled 167 ACS patients, 137 males (82%) and 30 females (18%); mean age of participants was 59.8 ± 11 years (32.5-78.5). The 12-months SPCRP was based on nurse counselling, multispecialistic visits and controlled training. Serial blood samples (plasma levels of TC, HDL C, LDL C, TG, Apo A, Apo B, hs-CRP, Nt-proBNP, Lp(a), UACR), BMI and WHR were assessed at baseline, at 6 and 12 months. A telephonic follow up [median of 36.2 months (27.7 – 77.0)] was performed to collect data. CONCLUSIONS: Among all the cardiac biomarkers considered only HDL C, Apo a and Nt-proBNP resulted to be independent predictors of cardiovascular mortality and re-hospitalization. Prognostic value of novel biomarkers in secondary cardiovascular prevention needs further investigations.