Biomarker Development in Cardiology: Reviewing the Past to Inform the Future

Abstract

Cardiac biomarkers have become pivotal to the clinical practice of cardiology, but there remains much to discover that could benefit cardiology patients. We review the discovery of key protein biomarkers in the fields of acute coronary syndrome, heart failure, and atherosclerosis, giving an overview of the populations they were studied in and the statistics that were used to validate them. We review statistical approaches that are currently in use to assess new biomarkers and overview a framework for biomarker discovery and evaluation that could be incorporated into clinical trials to evaluate cardiovascular outcomes in the future.

Inovatyvūs Širdies Nepakankamumo Biožymenys Ir Jų Galimybių Apžvalga

“…Ankstyvoji ŠN diagnostika, mirštamumas nuo ŠN ir hospitalizacijos rizikos vertinimas tebėra sudėtingas [1]. Kardiologijos praktikoje ir dabar naudojama tik keletas biožymenų, nors kiekvienais metais mokslininkai ieško naujovių ir būdų pagerinti ŠN diagnostiką ir stebėjimą [2]. Dėl vėlai diagnozuotos ligos ar blogai įvertintos jos rizikos, pacientas serga sunkesne ligos forma [3], todėl reikia ir toliau ieškoti inovatyvių būdų, leidžiančių geriau įvertinti ŠN eigą, prognozuoti hospitalizacijos bei mirties riziką.…”

Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

“…Available circulating biomarkers of ACS, e.g., cardiac troponin, have transformed ACS management, prognostication, and resource allocation [ 5 ]. However, there is an ongoing search for additional biomarkers to provide valuable mechanistic insights, and further improve diagnostic and prognostic accuracy [ 6 , 7 ]. Ideally, such biomarkers should be rapidly measurable and easily interpretable using robust and reproducible analytical methods [ 8 ].…”

“…Several proteins have been investigated as potential ACS biomarkers in view of their ability to reflect critical pathophysiological processes, e.g., atherosclerotic plaque instability, inflammation, myocardial cell injury, haemodynamic stress, and altered metabolism [ 6 , 7 ]. One such protein, albumin, has been shown to undergo chemical modifications, albeit the exact reactions remain elusive, during ischaemic states.…”

“…Several proteins have been investigated as potential ACS biomarkers in view of their ability to reflect critical pathophysiological processes, e.g., atherosclerotic plaque instability, inflammation, myocardial cell injury, haemodynamic stress, and altered metabolism [6,7].…”

Два метода определения содержания NT-proBNP, полуколичественный и количественный, для раннего выявления хронической сердечной недостаточности

“…NT-proBNP совместно с BNP образуется из прогормона proBNP кардиомиоцитами желудочков в ответ на перегрузку объемом или давлением [4]. И BNP, и NT-proBNP обнаруживаются в крови с помощью иммунохроматографического анализа, но NT-proBNP обладает некоторыми преимуществами [5]. NT-proBNP выводится только пассивно, главным образом почками.…”