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Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
Published on: September 26, 2018
Circulating biomarkers for predicting cardiovascular disease risk; a systematic review and comprehensive overview of
Thijs C van Holten1, Leonie F Waanders, Philip G de Groot
1Laboratory for Clinical Chemistry and Hematology, UMC Utrecht, Utrecht, The Netherlands. tholten@umcutrecht.nl
Insights
This review compares serological biomarkers for cardiovascular disease risk. Lipids are key for primary events, while ischemia markers predict secondary events. Fibrinogen strongly predicts stroke risk.
Area of Science:
- Biomarkers and Cardiovascular Health
- Atherothrombosis Research
- Clinical Risk Assessment
Background:
- Cardiovascular disease is a leading global cause of mortality.
- Accurate risk assessment is crucial for clinical decisions and treatment strategies.
- Serological biomarkers show promise for improving cardiovascular risk prediction.
Purpose of the Study:
- To systematically review meta-analyses of serological biomarkers for atherothrombosis.
- To compare the relevance of commonly studied biomarkers for cardiovascular disease risk.
- To identify key predictors for primary and secondary cardiovascular events and stroke.
Main Methods:
- Systematic review of meta-analyses identified through Medline and Embase searches.
- Studies categorized by patient groups (pre-existing disease, general population) and endpoints (cardiovascular disease, stroke).
- Identified 85 relevant articles comprising 214 meta-analyses.
Main Results:
- For primary cardiovascular events, predictive markers include C-reactive protein, fibrinogen, cholesterol, apolipoprotein B, apolipoprotein A/apolipoprotein B ratio, high-density lipoprotein, and vitamin D.
- For secondary cardiovascular events, markers are cardiac troponins I and T, C-reactive protein, serum creatinine, and cystatin C.
- Fibrinogen and serum uric acid are strong risk markers for primary stroke.
Conclusions:
- Lipid-associated markers are significant predictors for primary cardiovascular events.
- Ischemia-related markers are important for secondary cardiovascular events.
- Fibrinogen demonstrates strong predictive value for primary stroke.
Background:
Cardiovascular disease is one of the major causes of death worldwide. Assessing the risk for cardiovascular disease is an important aspect in clinical decision making and setting a therapeutic strategy, and the use of serological biomarkers may improve this. Despite an overwhelming number of studies and meta-analyses on biomarkers and cardiovascular disease, there are no comprehensive studies comparing the relevance of each biomarker. We performed a systematic review of meta-analyses on levels of serological biomarkers for atherothrombosis to compare the relevance of the most commonly studied biomarkers.
Methods And Findings:
Medline and Embase were screened on search terms that were related to "arterial ischemic events" and "meta-analyses". The meta-analyses were sorted by patient groups without pre-existing cardiovascular disease, with cardiovascular disease and heterogeneous groups concerning general populations, groups with and without cardiovascular disease, or miscellaneous. These were subsequently sorted by end-point for cardiovascular disease or stroke and summarized in tables. We have identified 85 relevant full text articles, with 214 meta-analyses. Markers for primary cardiovascular events include, from high to low result: C-reactive protein, fibrinogen, cholesterol, apolipoprotein B, the apolipoprotein A/apolipoprotein B ratio, high density lipoprotein, and vitamin D. Markers for secondary cardiovascular events include, from high to low result: cardiac troponins I and T, C-reactive protein, serum creatinine, and cystatin C. For primary stroke, fibrinogen and serum uric acid are strong risk markers. Limitations reside in that there is no acknowledged search strategy for prognostic studies or meta-analyses.
Conclusions:
For primary cardiovascular events, markers with strong predictive potential are mainly associated with lipids. For secondary cardiovascular events, markers are more associated with ischemia. Fibrinogen is a strong predictor for primary stroke.
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