Use of biomarkers to develop treatment strategies for atherosclerosis

This review focuses on the recent progress in and future prospects for the widened use of biomarkers of inflammation to modify lipid treatment goals in individuals assessed according to traditional risk factors to be at moderate or higher risk for clinical cardiovascular disease events. Elevated blood levels of high-sensitivity C-reactive protein or lipoprotein-associated phospholipase A(2) independently predict increased risk after adjustment for an individual's clinical risk status. When elevated individually, each is associated with an approximate doubling of risk for primary or recurrent cardiovascular events. Fourteen major studies, encompassing healthy adults, patients with chronic coronary heart disease, and those with a recent coronary event or stroke, are reviewed, demonstrating the consistent predictive value of these biomarkers across the risk spectrum. When both inflammatory markers are increased, they provide an even greater predictive capability to identify especially high-risk individuals who would benefit most from aggressive lipid-modifying therapies.