Development, validation and implementation of biomarker testing in cardiovascular medicine state-of-the-art: Proceedings of the European Society of Cardiology - Cardiovascular Round Table

Perry Elliott, Martin R Cowie, Jennifer Franke, André Ziegler, Charalambos Antoniades, Jeroen Bax, Chiara Bucciarelli-Ducci, Frank A Flachskampf, Christian Hamm, Magnus T Jensen, Hugo Katus, Alan Maisel, Theresa McDonagh, Clemens Mittmann, Pieter Muntendam, Eike Nagel, Giuseppe Rosano, Raphael Twerenbold, Faiez Zannad

Research output: Contribution to journalArticle (Academic Journal)

Abstract

Many biomarkers that could be used to assess ejection fraction, heart failure, or myocardial infarction fail to translate into clinical practice because they lack essential performance characteristics or fail to meet regulatory standards for approval. Despite their potential, new technologies have added to the complexities of successful translation into clinical practice. Biomarker discovery and implementation requires a standardised approach that includes: identification of a clinical need; identification of a valid surrogate biomarker; stepwise assay refinement, demonstration of superiority over current standard-of-care; development and understanding of a clinical pathway; and demonstration of real-world performance. Successful biomarkers should improve efficacy or safety of treatment, while being practical at a realistic cost. Everyone involved in cardiovascular healthcare, including researchers, clinicians, and industry partners, are important stakeholders in facilitating the development and implementation of biomarkers. This paper provides suggestions for a development pathway for new biomarkers, discusses regulatory issues and challenges, and suggestions for accelerating the pathway to improve patient outcomes. Real life examples of successful biomarkers-high sensitivity cardiac troponin (hs-cTn), T2* cardiovascular magnetic resonance (CMR) imaging, and echocardiography-are used to illustrate the value of a standardised development pathway in the translation of concepts into routine clinical practice.

Original languageEnglish
JournalCardiovascular Research
Early online date22 Sep 2020
DOIs
Publication statusE-pub ahead of print - 22 Sep 2020

Bibliographical note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions please email: journals.permissions@oup.com.

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