CDC/AHA Workshop on Markers of Inflammation and Cardiovascular Disease: Application to Clinical and Public Health...

Area of Science:

• Cardiovascular Medicine
• Biomarkers
• Inflammation Research

Background:

• Established cardiovascular disease risk factors are insufficient for predicting initial events.
• Inflammatory markers, including leukocyte count, serum amyloid A, and C-reactive protein (CRP), are increasingly investigated.
• Population studies and meta-analyses are crucial for evaluating novel biomarkers.

Framework:

• A meta-analysis of 11 prospective studies compared CRP levels in asymptomatic individuals.
• Individuals in the top CRP tertile showed a 2.0 odds ratio for coronary heart disease compared to the bottom tertile.
• These findings strongly suggest incorporating novel biomarkers into risk estimation.

Implementation:

• Standardization of inflammatory marker measurements is essential.
• Consideration of factors like measurement variability, correlation with existing factors, and evidence from diverse study types is necessary.
• Evaluation of impact on discrimination, calibration, and cost is critical for clinical utility.

Implications:

• New biomarkers can enhance the prediction of initial cardiovascular disease events.
• Developing sound strategies for implementing new testing is paramount.
• Demonstrating the benefit of testing requires leveraging existing risk factor data from large population studies.