Biomarkers for Prediction of Cardiovascular Events

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Abstract
Wang et al. (Dec. 21 issue)1 suggest that novel biomarkers in aggregate have little influence on the prediction of first cardiovascular events or death. We wonder whether there were sufficient analyses to warrant this conclusion. As described, there were only 68 “major” cardiovascular events in women and 101 in men. In the crucial multimarker analyses, a quarter of these events were eliminated owing to the obligatory inclusion of the urinary albumin-to-creatinine ratio in all the multimarker scores. Would these scores have been more useful if urine biomarkers had been excluded and 100% of the events included?