The validity of novel biomarkers in improving prediction and diagnosis of coronary heart disease : a case of Mengo Hospital

Abstract

Rising incidences of coronary heart disease is of great concern to public health especially among individuals without symptoms. This calls for accurate, early diagnosis which is the cornerstone for treatment, prognosis, and prevention. The novel biomarkers are tools that provide insight for the management of coronary heart disease. The purpose of this study was to evaluate validity of novel biomarkers in improving prediction and diagnosis of coronary heart disease among participants who are both symptomatic and asymptomatic. Furthermore, the lipid levels were determined. In addition, the novels biomarkers were compared to troponin as the gold standard. The accuracy of novel cardiac markers was determined. Using a cross section analysis, this study analyzed the validity of novel biomarkers in coronary heart disease at Mengo Hospital from the month of January 2014 to May 2015. It included one hundred twenty (120) participants aged 18-90 years. Both males 52 (40.3%) and females 68 (56.7%). The risk factors among study participants were obesity 40.3%. The study furthermore revealed (39.2%) low high density lipoprotein (HDL); participants with hypertriglyceridemia were (22.2%). The sensitivity and specificity of hs-CRP was correlated with troponin (85.6%, 81.7%; 90.5 %, 97.0%). The rest of cardiac markers were inferior to troponin in terms of sensitivity and specificity (AST, Myoglobin, LDH, CKMB, CK-NAK, 58.8%, 52.9%, and 29.4%, 57%, 73 %). The accuracy classification of hs-CRP in the ROC was 0.731 (95% CI 0.602-0.851) and myoglobin was 0.755 (95% CI, 0.648-0.861). The cost of biomarkers varied so much with in city laboratories which require review and standardization. Instead of requesting for traditional cardiac markers, only troponin alone can be requested as confirmatory test for coronary heart disease and hs-CRP as screening test. This study definitely answers the question of validity of novel biomarkers and their routine use in coronary heart disease management. Further studies are needed to establish the routine use of novel biomarkers in routine practice in Uganda hospitals.