To the Editor A recent study used a large multinational cohort to examine the incremental value of 5 cardiovascular biomarkers added to standard risk factors for predicting cardiovascular outcomes. Improvements in model performance resulting from the cardiovascular biomarkers (when added to a standard model based loosely on the pooled cohort equations) were reported using the C statistic and net reclassification improvement (NRI). Incremental changes in the C statistic mostly ranged from 0.01 to 0.04 and, consequently, the authors concluded that the addition of the cardiovascular biomarkers only led to a small improvement in risk prediction.