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1Department of Medical Laboratory Science, University of Massachusetts Dartmouth, N Dartmouth, MA 02747-2300, USA. ecarreiro@umassd.edu
Insights
Cardiovascular disease (CVD) risk assessment is evolving. New lab markers like hs-CRP and factors such as metabolic syndrome aid early detection and intervention strategies.
Area of Science:
- Cardiology
- Clinical Chemistry
Background:
- Cardiovascular disease (CVD) is a leading health concern in the U.S.
- Laboratory data assessment is crucial for CVD risk stratification and treatment.
- National Cholesterol Education Program (NCEP) ATP III guidelines incorporate lipid limits and risk factors like metabolic syndrome for early CVD detection.
Purpose of the Study:
- To review current laboratory assessments for cardiovascular disease (CVD) risk.
- To discuss emerging markers and factors influencing CVD development.
- To explore future directions in CVD risk assessment.
Main Methods:
- Literature review of established and emerging CVD risk factors.
- Analysis of current guidelines and laboratory testing protocols.
- Discussion of the role of endothelial dysfunction, inflammation, and metabolic imbalance.
Main Results:
- Guidelines now include lower lipid limits and conditions like metabolic syndrome for earlier CVD detection.
- High-sensitivity C-reactive protein (hs-CRP) is an adjunct marker for CVD risk.
- Interrelationships between factors like atherosclerosis, inflammation, and metabolic syndrome require further investigation.
Conclusions:
- Current CVD risk assessment integrates laboratory data, clinical guidelines, and emerging markers.
- Future assessments may incorporate metabolic by-products, genetic predisposition, and socioeconomic factors.
- Further research is essential to refine individual CVD risk prediction.
Abstract:
CVD remains the greatest health risk in the U.S.. Assessment of laboratory data in establishing risk and treatment modalities has come to the forefront in patient primary care. Guidelines published in the ATP III document by the NCEP have incorporated lower limits of lipids and included a number of risk factors and conditions, such as the metabolic syndrome associated with insulin-resistance, as a means for earlier detection and intervention in CVD. Endothelial dysfunction and the associated inflammatory process, including soluble plasma markers, have lead to the addition of hs-CRP as an adjunct to other laboratory indicators of CVD. The precise mechanisms and interrelationships between these factors and atherosclerosis have yielded some confusing data, along with investigations of a number of associated substances and conditions. An emerging theme is the body's response to injury and stress; a lack of metabolic balance. While currently outside the domain of routine laboratory testing, future CVD risk assessment may include the metabolic by-products generated by chronic external pressures, including genetic predisposition or alterations associated with socioeconomic factors. Further studies are needed to better understand the significance each plays in assessing the individual's development and CVD risk.
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