Author + information
- Thong Huy Cao, MD, PhD∗ ()
- ↵∗Department of Cardiovascular Sciences, University of Leicester and National Institute for Health Research, Leicester Biomedical Research Centre, Glenfield Hospital, University Road, Leicester, LE3 9QP, United Kingdom
I have read the paper by Evans et al. (1). The authors conducted a systematic review and meta-analysis of 67,063 patients with 4,165 incidents of heart failure from 16 prospective studies. The results in this study suggest that serum high-sensitivity cardiac troponin is strongly associated with the risk for incident heart failure beyond conventional risk factors. Certainly, Evans et al. (1) have conducted a very valuable and exciting study. However, the authors mentioned that they were not able to perform a quantitative meta-analysis of the C index data in this study because some studies did not report confidence intervals for C indexes and their changes. Could the authors calculate a quantitative meta-analysis of the C index only using fully reported studies? This would have provided a clearer view that would have interested many readers.
Furthermore, an individual participant data meta-analysis of N-terminal pro–B-type natriuretic peptide (NT-proBNP) concentration assessment was conducted from 40 prospective studies with 95,617 participants without a history of cardiovascular disease (2). The authors demonstrated that, in participants without baseline cardiovascular disease, NT-proBNP levels strongly predicted first-onset heart failure that could be used to integrate heart failure into primary prevention of cardiovascular diseases. Could Evans et al. (1) have done a further analysis to compare the performance of NT-proBNP or BNP level and high-sensitivity cardiac troponin as well as other biomarkers such as C-reactive protein if it was possible?
Please note: Dr. Cao is funded by the John and Lucille van Geest Foundation and the National Institute for Health Research Leicester Biomedical Research Centre.
- 2018 American College of Cardiology Foundation