Use of biomarkers to develop treatment strategies for atherosclerosis

Abstract

This review focuses on the recent progress in and future prospects for the widened use of biomarkers of inflammation to modify lipid treatment goals in individuals assessed according to traditional risk factors to be at moderate or higher risk for clinical cardiovascular disease events. Elevated blood levels of high-sensitivity C-reactive protein or lipoprotein-associated phospholipase A(2) independently predict increased risk after adjustment for an individual's clinical risk status. When elevated individually, each is associated with an approximate doubling of risk for primary or recurrent cardiovascular events. Fourteen major studies, encompassing healthy adults, patients with chronic coronary heart disease, and those with a recent coronary event or stroke, are reviewed, demonstrating the consistent predictive value of these biomarkers across the risk spectrum. When both inflammatory markers are increased, they provide an even greater predictive capability to identify especially high-risk individuals who would benefit most from aggressive lipid-modifying therapies.

Atrial Fibrillation and CHADS2 Risk Factors are Associated with Highly Sensitive C‐Reactive Protein Incrementally and Independently

“…In general, the association between AF and inflammation is well established, and several prior studies have documented the relationship with CRP 3,4,22–30 . Importantly, AF also increases other inflammatory markers as well, including complement (C3, C4), prothrombin fragments, and interleukin‐6 25,26 .…”

“…In our study, AF was associated with the increased mean CRP level across all levels of CHADS2 scores, which suggests that the association between AF and inflammation is not based on comorbidities alone. These data have clinical importance as CRP and other inflammatory marker elevations in patients with AF have been associated with worse outcomes such as death, stroke, and arrhythmia recurrence after cardioversion 27–30 . Furthermore, these data assist in defining AF as a risk factor in addition to a risk marker of other diseases.…”

Intimomedial thickness of the vertebral arteries complex: A new useful parameter for the assessment of atheroclerotic process?

“…Supklinička faza ateroskleroze je oštećenje endotela i postepeno difuzno zadebljanje IMK 14,15,[34][35][36][37][38][39][40] . Informacija o ovom procesu se ne može dobiti angiografijom ili nuklearnom magnetnom rezonancom (MRI) 35,36 .…”

“…Informacija o ovom procesu se ne može dobiti angiografijom ili nuklearnom magnetnom rezonancom (MRI) 35,36 . To je neinvazivno i moćno sredstvo u dijagnostikovanju, merenju i praćenju procesa ateroskleroze 2,7,12,15,26,34,37,[41][42][43][44] . To je neinvazivno i moćno sredstvo u dijagnostikovanju, merenju i praćenju procesa ateroskleroze 2,7,12,15,26,34,37,[41][42][43][44] .…”

Emerging inflammatory markers for assessing coronary heart disease risk

“…Observational and epidemiologic studies demonstrated that elevated levels of sPLA 2 [29] or Lp-PLA 2 [30] predict increased risk of CHD events and stroke, with Lp-PLA 2 predicting risk independently of CRP [31]. Important evidence supporting a pathophysiologic role for Lp-PLA 2 in atherosclerosis progression was presented by Lavi et al [32] in work demonstrating that in subjects with nonobstructive atherosclerosis detected by intravascular ultrasound, the coronary circulation becomes a net producer of Lp-PLA 2 and lyso-PC.…”