[Biochemical markers of atherosclerotic disease]

Although the expanding body of research has established firm evidence for the value of some biochemical markers in patients with cardiovascular disease, it has also deluged the clinical and research communities with candidate biomarkers, but very few of them are likely to survive the test of time as useful clinical tool.

Acute coronary syndrome refers to a constellation of clinical symptoms caused by acute myocardial ischemia. Guidelines for utilization of biochemical markers in acute coronary syndromes are involved in recommendations for use of biomarkers in the initial evaluation of patients with nontraumatic chest symptoms, for diagnosis of myocardial infarction, as well as recommendations for early risk stratification of subsequent death and/or recurrent ischemic event. So, in acute coronary syndromes these biochemical markers are applied: of myocardial necrosis, of cardiac injury, of inflammation, of ischemia and of ventricular wall stress.

When coronary heart disease is concerned, the central place in froreseeing the appearance and development of this disease, is given to risk factors, among them which is a great number of biomarkers. According to all guidelines for cardiovascular disease prevention, lipid parameters represent strong predictors of atherogenesis and coronary heart disease.

The consistent conjunction with atherosclerosis is also mainifested by circulating markers of inflammation. In spite of lack of evidence on measuring the C-reactive protein in a wide population, the guidelines for its application in diagnostics and therapy of coronary heart disease have been developed. In emerging risk factor group there are: homocysteine, prothrombogenic and genetic factors. New potential markers of atherosclerosis include adipocytokines, markers of endothelial function, immunological markers, as well as markers of hepatic and renal dysfunction.