Novel biomarkers for cardiovascular risk prediction among professional divers

UDC: 
613.2
DOI: 
10.21668/health.risk/2025.1.11.eng
Authors: 

H. Salah, R.M. El-Gazzar, E.W. Abd El-Wahab, F. Charl

Organization: 

Alexandria University, High Institute of Public Health, 22 El-Gaish Rd, Alexandria, 542404, Egypt

Abstract: 

The study relevance is associated with remote negative effects produced by diving on health and related to high fatality rates. Research on cardiovascular risk assessment (CVRA) in divers is scarce. We aimed to evaluate the accuracy of some novel biomarkers versus an established cardiovascular risk estimator in CVRA among professional divers.

A comparative cross-sectional study was conducted on a total of 50 professional divers and an equal number of marine seafarers. Participants were clinically evaluated and subjected to electrocardiography (ECG), basic biochemical analyses, and assessment of some trace metals and oxidative stress biomarkers (OSBMs). Optimal, 10 years, and lifetime CVR was assessed by the Atherosclerotic Cardiovascular Disease (ASCVD) risk estimator. A predictive model for CVR among professional divers was built by testing the performance of some novel biomarkers versus the ASCVD risk estimator.

According to our findings, the professional divers and seafarers showed increased 10 years and lifetime CVD risk compared to the optimal, although the divers were at a higher risk and showed noticeable electrophysiological changes. A proposed model comprising significant CVR predictors and elements of the ASCVD risk estimator improved its performance in CVRA. Corrected QT wave interval was accurate in CVD risk definition and stratification in divers and seafarers (AUC (95 % C.I.) = 0.692 (0.584–0.800), sensitivity = 60.0 %, specificity = 84.0 %, PPV = 78.9, NPV = 67.7, p < 0.001).

Therefore, the CVD risk in divers is quite high and including CVRA in their periodic examinations is crucial. Adding selected biomarkers, particularly ECG changes and some OSBMs with elements of the ASCVD risk estimator improves its accuracy in CVRA.

Keywords: 
risk factors, cardiovascular risk estimators, biomarkers, ECG changes, occupational diseases, oxidative stress biomarkers, professional diving
Salah H., El-Gazzar R.M., Abd El-Wahab E.W., Charl F. Novel biomarkers for cardiovascular risk prediction among pro-fessional divers. Health Risk Analysis, 2025, no. 1, pp. 114–127. DOI: 10.21668/health.risk/2025.1.11.eng
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Received: 
15.01.2025
Approved: 
04.03.2025
Accepted for publication: 
20.03.2025

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