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Cardiac risk factors: biomarkers and genetic tests to determine cardiovascular risk

David Anthony1, Paul George2, Charles B Eaton3

  • 1Memorial Hospital of Rhode Island, 111 Brewster St, Pawtucket, RI 02903, david_anthony@brown.edu.

FP Essentials
|June 18, 2014
PubMed

Insights

Assessing coronary heart disease (CHD) risk involves multiple tools, including Framingham Risk Score and newer Pooled Cohort Equations. Biomarkers like C-reactive protein and lipoprotein (a) can refine CHD risk prediction.

Area of Science:

  • Cardiology
  • Biomarkers
  • Risk Assessment

Background:

  • Current guidelines emphasize global risk assessment for coronary heart disease (CHD).
  • Established tools include the Framingham Risk Score (FRS) and Pooled Cohort Equations for 10-year risk prediction.
  • Emerging biomarkers offer potential for enhanced risk stratification.

Observation:

  • High-sensitivity C-reactive protein and family history improve CHD risk prediction when integrated into the Reynolds Risk Score.
  • Elevated urinary albumin correlates with higher CHD event rates, though its incremental predictive value is modest.
  • Lipoprotein (a) [Lp(a)] elevation predicts increased CHD risk, particularly in those with a family history of premature disease.
  • Platelet-activating factor acetylhydrolase (Lp-PLA2) is another biomarker indicating elevated risk.

Findings:

  • The Reynolds Risk Score refines 10-year CHD risk by incorporating inflammation biomarkers and family history into the FRS.
  • Urinary albumin and Lp(a) show predictive value for CHD events, with Lp(a) testing recommended in specific clinical scenarios.
  • Lp-PLA2 levels may influence treatment goals, such as low-density lipoprotein targets during statin therapy.

Implications:

  • Integrating multiple biomarkers and clinical factors provides a more comprehensive assessment of individual CHD risk.
  • Further research into genetic risk factors may lead to more personalized CHD prevention strategies in the future.
  • Refined risk assessment can guide more targeted and effective preventive interventions for coronary heart disease.

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