Inflammatory Markers in Cardiovascular Disease; Lessons Learned and Future Perspectives

Abstract

Background: Cardiovascular disease (CVD) still remains the leading cause of morbidity and mortality worldwide. It is now established that inflammation plays a crucial role in atherosclerosis and atherothrombosis, and thus, it is closely linked to cardiovascular disease. Objective: The aim of the present review is to summarize and critically appraise the most relevant evidence regarding the potential use of inflammatory markers in the field of CVD. Method: We conducted a comprehensive research of the relevant literature, searching MEDLINE from its inception until November 2018, primarily for meta-analyses, randomized controlled trials and observational studies. Results: Established markers of inflammation, mainly C-reactive protein, have yielded significant results both for primary and secondary prevention of CVD. Newer markers, such as lipoprotein-associated phospholipase A2, lectin-like oxidized low-density lipoprotein receptor-1, cytokines, myeloperoxidase, cell adhesion molecules, matrix metalloproteinases, and the CD40/CD40 ligand system, have been largely evaluated in human studies, enrolling both individuals from the general population and patients with established CVD. Some markers have yielded conflicting results; however, other are now recognized not only as promising biomarkers of CVD, but also as potential therapeutic targets, establishing the role of anti-inflammatory and pleiotropic drugs in CVD. Conclusion: There is significant evidence regarding the role of consolidated and novel inflammatory markers in the field of diagnosis and prognosis of CVD. However, multimarker model assessment, validation of cut-off values and cost-effectiveness analyses are required, in order for those markers to be integrated into daily clinical practice.

The relation of common inflammatory cytokines with anxiety and depression and their values in estimating cardiovascular outcomes in coronary heart disease patients

“…Inflammatory cytokines are previously reported to be overexpressed in cerebro‐cardiovascular disease patients. 22 For instance, TNF‐α and IL‐17 are elevated in CHD patients and AIS patients, respectively. 23 , 24 In line with previous studies, it was observed that pro‐inflammatory cytokines TNF‐α, IL‐1β, IL‐6, and IL‐17A were elevated in CHD patients compared to HCs since pro‐inflammatory cytokines heavily participated in atherosclerotic plaque formation and CHD pathogenesis, thus led to CHD occurrence.…”

“…Inflammatory cytokines are previously reported to be overexpressed in cerebro‐cardiovascular disease patients 22 . For instance, TNF‐α and IL‐17 are elevated in CHD patients and AIS patients, respectively 23,24 .…”

Pro-Inflammatory and Pro-Oxidative Changes During Nilotinib Treatment in CML Patients: Results of a Prospective Multicenter Front-Line TKIs Study (KIARO Study)

“…We also observed a progressive increase in oxLDL levels during nilotinib treatment, but not during imatinib or dasatinib. The combination of inflammatory and oxidative mechanisms that are closely related in atherogenesis and atherothrombotic complications (22,23), may eventually be responsible for nilotinib-associated endothelial activation and the consequent expression of pro-atherogenic adhesion molecules (10) with effects on macrophages and increased LOX-1 expression by these same cells (24). LOX-1, then, mediates oxLDL accumulation in the intima with atherosclerotic plaque growth but it also increases transcription and activity of proteases, responsible for plaque instability and rupture (25)(26)(27)(28) In addition to the pathogenetic aspect, the relevance of the link between inflammatory mechanisms and lipid oxidation is also demonstrated by the reduction of clinical events as evidenced by the outcome of recent intervention trials where a specific anti-inflammatory therapy has been associated with statin treatment (29).…”

Assessment of Systemic Immune-Inflammation Index and Systemic Inflammation-Response Index in Different Coronary Artery Plaque Types

“…It has been shown that changes in peripheral blood composition, which reflect the inflammatory condition of the human body, have prognostic value for various diseases, including cardiac diseases. 12 The systemic immune-inflammation index (SII) and systemic inflammation-response index (SIRI), which are calculated based on peripheral blood count values, are two novel biomarkers that might provide additional information that traditional risk factors cannot provide. 13 These biomarkers have been found to be related to increased risk of stroke and all-cause mortality in the general population.…”