TY - JOUR
T1 - Development, validation and implementation of biomarker testing in cardiovascular medicine state-of-the-art
T2 - Proceedings of the European Society of Cardiology - Cardiovascular Round Table
AU - Elliott, Perry
AU - Cowie, Martin R
AU - Franke, Jennifer
AU - Ziegler, André
AU - Antoniades, Charalambos
AU - Bax, Jeroen
AU - Bucciarelli-Ducci, Chiara
AU - Flachskampf, Frank A
AU - Hamm, Christian
AU - Jensen, Magnus T
AU - Katus, Hugo
AU - Maisel, Alan
AU - McDonagh, Theresa
AU - Mittmann, Clemens
AU - Muntendam, Pieter
AU - Nagel, Eike
AU - Rosano, Giuseppe
AU - Twerenbold, Raphael
AU - Zannad, Faiez
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions please email: [email protected].
PY - 2020/9/22
Y1 - 2020/9/22
N2 - 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.
AB - 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.
U2 - 10.1093/cvr/cvaa272
DO - 10.1093/cvr/cvaa272
M3 - Article (Academic Journal)
C2 - 32960964
SN - 0008-6363
JO - Cardiovascular Research
JF - Cardiovascular Research
ER -