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CompletedNCT05704569Updated Mar 15, 2023

Prediction of Primary Cardiovascular Events Using the Multimarker Approach

An observational study in Cardiovascular Diseases, Stroke and Myocardial Infarction, sponsored by Karaganda Medical University. Completed. Open to participants aged 25 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-03-15.

Sponsored by Karaganda Medical University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
1,500
Ages
25 Years to 65 Years
Sex
All
01

Study summary

The study of biochemical risk factors for cardiovascular diseases is important not only for analysis, but also for preventive measures, given that changes in the level of biomarkers can be detected before the first clinical manifestations of CVD. Accordingly, patients at high CV risk may have additional motivation to lead a healthy lifestyle. In addition, information on biochemical risk markers can be used to optimize the clinical management of patients.

Read the detailed description

Recruitment of 1500 people randomly without previous cardiovascular events. Examination, questioning of patients, laboratory tests. Patient follow-up for 6 years. Registration of the facts of the occurrence of cardiovascular events.

Cohort study with a retrospective and prospective component

Stage I (Conducted in 2014 as part of the scientific and technical project "Environmental risks and public health")

  1. Questionnaire and general clinical examination (anthropometry, measurement of blood pressure, BMI, WC)
  2. determination of cholesterol, glucose and total cardiovascular risk according to the SCORE scale
  3. Determination of the quality of life, the level of depression and anxiety, the level of physical activity.

For an in-depth biochemical blood test for onco- and cardiomarkers, the MILLIPLEX MAP Human panel was used. This panel allows you to simultaneously study 23 onco- and 11 cardiac markers, which are the most common among oncological and cardiac diseases. Tumor markers included: alpha-fetoprotein (Afp), carbohydrate antigen 125 (CA125), carbohydrate antigen 15-3 (CA15-3), cancer embryonic antigen (CEA), cytokeratin fragment 19 (CYFRA21-1), fibroblast growth factor 2 (FGF2), human epididymis protein 4 (HE4), hepatocyte growth factor (HGF-α), interleukin 6 (IL6), interleukin 8 (IL8), leptin (LEPTIN), anti-Mullerian hormone (MIF), osteopontin (OPN ), prolactin (PROLACTIN), common prostate specific antigen (PSAtotal), cystatin C (SCF), apoptosis inducer (SFAS), transforming growth factor (TGF-α), tumor necrosis factor (TNF), TRAIL, vascular endothelial growth factor ( VEGF), Beta chorionic gonadotropin (bHCG), apoptosis inducer L (SFAS) L.

In respondents with cardiovascular risk (1% or more on the SCORE scale), the level of cardiomarkers was determined. Cardiomarkers included: creatine kinase MB (CK MB), chemokine C-X-C motif, ligand 16 (CXCL16), fatty acid binding protein, cardiac form (FABP3), N-terminal fragment of the brain natriuretic peptide (NT-ProBNP), oncostatin M (OSM), placental growth factor isoform (PIGF 4), C-X-C motif chemokine, ligand 6 (CXCL6), endocan 1 (ENDOCAN1), fatty acid binding protein 4 (FABP-4), TNF superfamily protein ( LIGHT), troponin I (TROPONINI).

Determination of the content of biochemical markers in the blood (carried out at the Collective Use Laboratory of the NJSC "Medical University of Karaganda").

STAGE II Prospective observation for 6 years, For a cardiovascular event we take the development of: Acute forms of ischemic disease (ACS with and without ST-segment elevation / myocardial infarction), chronic forms of IHD-angina pectoris, Acute cerebrovascular accident, transient ischemic attack, Lethal outcome from CVD, death from all causes.

Statistical data processing will be carried out using the SPSS program (version 22.0). Quantitative variables with a normal distribution will be presented as mean values and their standard deviations (M ± SD), with a difference from the normal distribution - median and interquartile range (Me (IQR). Dichotomous signs are presented as shares (absolute number of patients (%) Descriptive statistics will use the Mann-Whitney U-test for independent samples to compare quantitative data, categorical data will be analyzed using Pearson's χ2, Spearman's (Rho) correlation analysis will be used to determine the relationship between parameters, Using binary logistic regression (one-way and multivariate) if independent predictors of the NSS and the odds ratio (OR) are established at a 95% confidence interval (CI) for each factor.Based on the results of multivariate regression analysis on the values of exp(B) of significant variables and constants, a predictive model will be built, predictive value ( specificity, h Sensitivity, % of false positive and false negative results. Cox regression, Kaplan-Meier survival analysis will also be used, there will be a comparison of C-statistics of models. The critical level of significance (p) when testing statistical hypotheses will be taken as 0.05.

02

Conditions studied

  • Cardiovascular Diseases
  • Stroke
  • Myocardial Infarction
  • Death
  • Coronary Artery Disease

Keywords

  • CVD
  • biomarkers
  • prognosis
  • MI
  • stroke
  • CV mortality
  • CV morbidity
03

In context

Cardiovascular Diseases

4,904 studies on the registry are indexed under Cardiovascular Diseases; 919 are open to participants now.

This study's enrollment of 1,500 is above the median of 573 across 1,485 observational studies indexed under Cardiovascular Diseases.

Browse Cardiovascular Diseases studies →

Lead sponsor

Karaganda Medical University is the lead sponsor of 10 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
25 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

persons living in the Republic of Kazakhstan, aged 25 to 65 years without previous cardiovascular events

Eligibility criteria

iInclusion Criteria:

  • respondents living in the territory of the Republic of Kazakhstan from 25 to 65 years without previous cardiovascular events.

Exclusion criteria:

  • pregnant women;
  • persons with mental and severe neurological diseases;
  • survivors of an acute event associated with atherosclerosis;
  • persons with diagnosed chronic forms of coronary artery disease;
  • persons with verified CHF;
  • persons with myocarditis and cardiomyopathies of various origins,
  • congenital and acquired heart defects,
  • atherosclerosis of peripheral arteries.
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
1,500 participants (actual)
Patient registry
No

Groups and cohorts

  • the outcome group

    The composite endpoint included the presence of any of the following events: cardiovascular death, MI, stroke, hospitalization and/or application due to CHD, and transient ischemic attack

    Diagnostic Test: measurement of multiple biomarkers

  • no-outcome group

    individuals who did not experience any events during the observation period

    Diagnostic Test: measurement of multiple biomarkers

Interventions

  • Diagnostic testmeasurement of multiple biomarkers

    All patients were tested for glucose and cholesterol levels. The capillary blood glucose level was measured by an electrochemical method using an Accu-Chek Active by AkkuChek blood glucose meter. The DM was considered to be verified when there were criteria which the World Health Organization (WHO) set in 2001: glucose concentration in whole blood is \>6.1 mmol/l, and glucose concentration is \>11.1 mmol/l in random measurement. Plasma for the study was obtained via the standard phlebotomy technique from ethylenediaminetetraacetic acid (EDTA) anticoagulants. Plasma was aliquoted into cryovials and got frozen quickly. The samples were stored in a low-temperature refrigerator (-70°C) until the study commencement (up to 3 months). All biomarkers were measured by magnetic bead-based multiplex immunofluorescence assay through the Xmap technology using the Milliplex map Human CVD Magnetic Bead Panel 1 (Millipore)

06

What researchers measure

Primary outcomes

  1. number of respondents with stroke or transient ischemic attack

    stroke was defined as a sudden onset of nonconvulsive and focal neurological deficit due to ischemia or hemorrhage that lasts \>24 hours, and it is transient ischemic attack if neurological recovery occurred within 24 hours. \&e diagnosis of stroke and the transient ischemic attack was based on the disease history, neurological examination, and all available clinical data, including computed tomography (CT)/magnetic resonance imaging (MRI) results.

    Time frame: 66 months

  2. Number of respondents with Coronary heart disease

    Coronary heart disease included myocardial infarction, sudden cardiac death, and newly diagnosed angina. The criteria for MI were at least two of the following: (1) typical symptoms, including prolonged severe anterior chest pain; (2) elevated cardiac enzymes-higher than twice the upper limit of the standard values; sudden cardiac death within 1 hour of the acute condition onset; (3) progressive diagnostic electrocardiographic changes. The cases of newly diagnosed angina were determined based on typical angina-type pain, reversed by the use of nitrates, confirmed by a doctor's examination, and via the electrocardiography (ECG) exercise test.

    Time frame: 66 months

  3. Number Of respondents wirh cardiovascular death

    death reported as a complication of cardiovascular disease

    Time frame: 66 months

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Pareek M, Bhatt DL, Vaduganathan M, Biering-Sorensen T, Qamar A, Diederichsen AC, Moller JE, Hindersson P, Leosdottir M, Magnusson M, Nilsson PM, Olsen MH. Single and multiple cardiovascular biomarkers in subjects without a previous cardiovascular event. Eur J Prev Cardiol. 2017 Oct;24(15):1648-1659. doi: 10.1177/2047487317717065. Epub 2017 Jun 23. PubMed 28644092 ↗
  • Pauli N, Puchalowicz K, Kuligowska A, Krzystolik A, Dziedziejko V, Safranow K, Rac M, Chlubek D, Ewa Rac M. Associations between IL-6 and Echo-Parameters in Patients with Early Onset Coronary Artery Disease. Diagnostics (Basel). 2019 Nov 14;9(4):189. doi: 10.3390/diagnostics9040189. PubMed 31739518 ↗
  • Shi C, van der Wal HH, Sillje HHW, Dokter MM, van den Berg F, Huizinga L, Vriesema M, Post J, Anker SD, Cleland JG, Ng LL, Samani NJ, Dickstein K, Zannad F, Lang CC, van Haelst PL, Gietema JA, Metra M, Ameri P, Canepa M, van Veldhuisen DJ, Voors AA, de Boer RA. Tumour biomarkers: association with heart failure outcomes. J Intern Med. 2020 Aug;288(2):207-218. doi: 10.1111/joim.13053. Epub 2020 May 5. PubMed 32372544 ↗
  • Bracun V, Suthahar N, Shi C, de Wit S, Meijers WC, Klip IT, de Boer RA, Aboumsallem JP. Established Tumour Biomarkers Predict Cardiovascular Events and Mortality in the General Population. Front Cardiovasc Med. 2021 Dec 8;8:753885. doi: 10.3389/fcvm.2021.753885. eCollection 2021. PubMed 34957244 ↗
  • Chatzinikolaou A, Tzikas S, Lavdaniti M. Assessment of Quality of Life in Patients With Cardiovascular Disease Using the SF-36, MacNew, and EQ-5D-5L Questionnaires. Cureus. 2021 Sep 14;13(9):e17982. doi: 10.7759/cureus.17982. eCollection 2021 Sep. PubMed 34667665 ↗
  • Kwee LC, Neely ML, Grass E, Gregory SG, Roe MT, Ohman EM, Fox KAA, White HD, Armstrong PW, Bowsman LM, Haas JV, Duffin KL, Chan MY, Shah SH. Associations of osteopontin and NT-proBNP with circulating miRNA levels in acute coronary syndrome. Physiol Genomics. 2019 Oct 1;51(10):506-515. doi: 10.1152/physiolgenomics.00033.2019. Epub 2019 Sep 18. PubMed 31530226 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 15, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05704569
Lead sponsor
Karaganda Medical University
Responsible party
Sponsor
First posted
Jan 30, 2023
Start date
Jun 1, 2014
Primary completion
Mar 1, 2020
Completion
Dec 1, 2022
Last update
Mar 15, 2023

Study contacts

Lyudmila Turgunova, MD, PhD, ScD
principal investigator · Karaganda Medical University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2023. You cannot join it, but the record below documents what was studied.

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