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[Cardiovascular prevention: new biochemical plasmatic markers of risk]
1Dipartimento Medicina Interna, Università degli Studi di Pisa, Pisa, Italy.
Insights
Primary prevention of acute coronary syndromes remains challenging. New biochemical markers for inflammation, infection, endothelial activation, and metabolism offer potential, but a gap exists in clinical application for cardiovascular disease risk.
Area of Science:
- Cardiology
- Preventive Medicine
- Biochemistry
Background:
- Primary prevention of acute coronary syndromes (ACS) is a critical public health issue.
- Advances in understanding cardiovascular disease (CVD) risk have identified numerous novel biochemical markers.
- A significant gap persists between scientific discovery and clinical implementation of preventive strategies.
Purpose of the Study:
- To critically analyze and update the current understanding of biochemical markers for cardiovascular disease risk.
- To highlight the challenges in translating scientific progress into effective primary prevention strategies for ACS.
- To emphasize the need for a population-based approach to cardiovascular health.
Main Methods:
- Review and synthesis of current scientific literature on cardiovascular disease risk markers.
- Analysis of plasmatic markers including inflammation (serum amyloid A, C-reactive protein, phospholipase A2), infection (Chlamydia pneumoniae, cytomegalovirus), endothelial activation (ICAM-1, VCAM-1), immunological markers (autoantibodies against oxidized LDL), hemostatic markers (TFPI, PAI-1), and metabolic indices (Lpa, homocysteine).
- Critique of the current gap between research findings and clinical practice in primary CVD prevention.
Main Results:
- Numerous biochemical markers associated with inflammation, infection, endothelial dysfunction, and metabolic disturbances have been identified as potential indicators of cardiovascular risk.
- These markers include serum amyloid A, C-reactive protein, Chlamydia pneumoniae seropositivity, ICAM-1, VCAM-1, autoantibodies against oxidized LDL, TFPI, PAI-1, Lpa, and homocysteine.
- The study identifies a notable disparity between the rapid advancement of scientific knowledge and its practical application in clinical settings for the primary prevention of cardiovascular diseases.
Conclusions:
- The identification of novel biochemical markers provides new avenues for the primary prevention of cardiovascular diseases.
- Bridging the gap between scientific discovery and clinical practice is essential for effective public health interventions.
- A population-focused strategy is crucial for addressing the complexities of cardiovascular disease prevention in a global context.
Abstract:
The primary prevention of acute coronary syndromes is an open question. The scientific progress has discovered new biochemical markers of cardiovascular disease risk that may be useful for primary prevention. They are plasmatic markers of inflammation (serum amyloid A, C-reactive protein, phospholipase A2) and of infection (seropositivity to Chlamydia pneumoniae, cytomegalovirus). They are plasmatic markers of endothelial activation (adhesion molecules such as ICAM-1, VCAM-1) immunological markers (autoantibodies against oxydized LDL, hemostatic markers (TFPI, PAI-1) and metabolic indices (Lpa, homocystein). A gap is evident between the scientific progress in the knowledge of the epidemiology of cardiovascular pathology and its application in clinical practice. The priority should become the population approach to primary prevention: the rapidly changing and complex global context presents new challenges for public health practitioners struggling to implement preventive policies and programmes. New risk factors of cardiovascular disease have been pointed out by research. This study shows the situation on the topic with critique and updated analysis.