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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Inflammatory and long-term risk markers
1Department of Pathology and Laboratory Medicine and Laboratory Service, Department of Veterans Affairs Medical Center, 800 Zorn Avenue, Louisville, KY 40206, USA. levinson@louisville.edu
Insights
Inflammatory markers like C-reactive protein show potential for predicting atherosclerosis risk. However, no current markers meet criteria for routine clinical screening and risk stratification.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Biomarker Discovery
Background:
- Atherosclerosis is a complex disease with a significant inflammatory component.
- Inflammation plays a crucial role in the development and progression of atherosclerotic plaques.
- Identifying reliable inflammatory markers is key for assessing cardiovascular disease risk.
Purpose of the Study:
- To review the evidence for inflammatory markers in atherosclerosis risk prediction.
- To evaluate the clinical utility of specific inflammatory markers.
- To discuss criteria for clinically useful diagnostic and prognostic tests.
Main Methods:
- Systematic review of studies evaluating fibrinogen, hs-CRP, IL-6, MPO, and sCD40L.
- Analysis of relative risk and clinical utility criteria for risk assessment tools.
- Discussion of the challenges in establishing marker usefulness for clinical practice.
Main Results:
- Current evidence does not establish clinically useful inflammatory markers for routine atherosclerosis screening or risk stratification.
- Prospective studies are required to validate the predictive value of existing markers.
- Significant challenges exist in demonstrating that current inflammatory markers meet the necessary criteria for clinical application.
Conclusions:
- Clinically validated inflammatory markers for atherosclerosis risk prediction are not yet established.
- Further research, including robust prospective studies, is needed to confirm the utility of current markers.
- Understanding the fundamental mechanisms of inflammation in atherosclerosis may be essential for discovering truly predictive biomarkers.
Abstract:
Evidence indicates that the process of atherosclerosis has an inflammatory component. Markers of inflammation have been explored as a means for assessing (predicting) risk for the disease. Studies that evaluated the usefulness of fibrinogen, highly sensitive C-reactive protein, interleukin-6, myeloperoxidase, and soluble CD40 ligand for risk prediction are reviewed. Criteria for identifying a clinically useful test are discussed, along with the use of relative risk as a means for making clinically useful comparisons. It is concluded that clinically useful markers for routine screening and risk stratification have not been established, that prospective studies will be necessary to confirm the usefulness of current markers, and that on the basis of current knowledge, it will be a challenge to show that any of those inflammatory markers discussed herein will meet the needed criteria. Continued research into basic mechanisms by which inflammation acts in atherosclerosis may be necessary to identify useful markers for prediction.
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