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Published on: January 28, 2020
Inflammatory biomarkers of the patient with myocardial insufficiency
1Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. gblake@partners.org
Insights
Inflammation markers, like C-reactive protein, predict cardiovascular events independently of traditional risk factors. These markers may also identify patients who benefit most from interventions like statin therapy.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Vascular Biology
Background:
- Inflammation is integral to atherosclerosis development and complications.
- Plasma inflammatory markers predict future cardiovascular events, including death, myocardial infarction, and stroke.
- This predictive value is independent of traditional risk factors like lipids and troponin levels.
Purpose of the Study:
- To review the role of inflammation in atherosclerosis.
- To highlight the predictive value of inflammatory markers for cardiovascular events.
- To explore the potential of inflammatory markers in guiding therapeutic interventions.
Main Methods:
- Review of recent clinical studies and data.
- Analysis of inflammatory marker levels in large cohorts, including apparently healthy individuals.
- Evaluation of the association between inflammatory markers and outcomes of cardiovascular interventions.
Main Results:
- C-reactive protein (CRP) shows predictive value comparable to low-density lipoprotein cholesterol in over 27,000 women.
- Inflammatory markers predict cardiovascular events independently of traditional risk factors.
- Emerging data suggest interventions like statin therapy may be more effective in patients with elevated inflammation markers.
Conclusions:
- Understanding vascular biology and clinical data on inflammation refines cardiovascular disease diagnosis and treatment.
- Inflammatory markers offer valuable insights beyond traditional risk assessment.
- Targeting inflammation may enhance the efficacy of cardiovascular therapies.
Purpose Of Review:
Inflammation plays a central role in the genesis of atherosclerosis and its complications. In this regard, plasma levels of several markers of inflammation have been shown to predict risk of future cardiovascular events, including cardiovascular death, myocardial infarction, and ischemic stroke. Furthermore, the predictive value of inflammatory markers is independent of traditional risk markers such as lipid levels, or cardiac troponin levels among those with acute coronary syndromes.
Recent Findings:
Indeed, recent data suggest that among more than 27,000 apparently healthy women, the predictive value of C-reactive protein, the most extensively studied marker of vascular inflammation, was at least as good as that of low-density lipoprotein cholesterol. In addition, hypothesis-generating data suggest that the benefits of proven interventions such as statin therapy and glycoprotein IIb/IIIa receptor blockade may be most effective among those with elevated markers of inflammation.
Summary:
Combining our evolving understanding of the vascular biology of atherosclerosis with clinical studies of inflammatory markers and mediators may help refine our diagnostic and therapeutic armamentarium for cardiovascular disease.
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