Non-Traditional Cardiovascular Risk Markers in the Era of Established Major Risk Factors and Multiple Guidelines

Area of Science:

• Cardiovascular Medicine
• Biochemistry
• Inflammation Research

Background:

• Cardiovascular disease (CVD) understanding has evolved from purely mechanistic to incorporating metabolic and molecular etiologies.
• Historically, CVD treatments focused on surgical interventions for blood flow, neglecting underlying risk factors.
• Atherosclerosis and CVD were previously viewed as mechanistic events with limited attention to metabolic origins.

Purpose of the Study:

• To highlight key non-traditional cardiovascular risk factors.
• To emphasize their role in confirming CV risk and understanding atherogenesis.
• To guide current and future therapeutic approaches for cardiovascular disease.

Main Methods:

• Review and synthesis of clinical literature on non-traditional cardiovascular risk factors.
• Analysis of the role of specific biomarkers such as apolipoprotein A (ApoA), apolipoprotein B (ApoB), high-sensitivity C-Reactive protein (hsCRP), and lipoprotein (a) [Lp(a)].
• Exploration of the link between inflammation and atherogenesis.

Main Results:

• Identified several non-traditional risk factors including ApoA, ApoB, hsCRP, homocysteine, interleukin 1 (IL1), Lp(a), LDL particle density and number, tissue/tumor necrosis factor-α (TNF-α), and uric acid.
• These factors provide additional confirmation of significant CV risk.
• They enhance understanding of inflammatory mechanisms in atherogenesis.

Conclusions:

• Non-traditional risk factors are clinically significant for assessing and managing cardiovascular risk.
• These markers offer valuable insights into the inflammatory pathways of atherogenesis.
• Failure to address established CV risk factors, including newer ones, is increasingly viewed as medical negligence, though challenges in prevention and treatment persist.