[Remarks on biomarkers of cardiovascular risk]

Area of Science:

• Clinical chemistry
• Cardiovascular diagnostics
• Metrology

Background:

• Cardiovascular risk assessment relies on laboratory diagnostics.
• Key factors include metrology, traceability, and quality assessment.
• Biological variation and reference change value are crucial for interpreting results.

Purpose of the Study:

• To review the state-of-the-art in routine laboratory diagnostics for cardiovascular risk.
• To identify areas needing improvement in analytical quality and standardization.
• To highlight the role of biological variation in lipid diagnostics.

Main Methods:

• Review of current methodologies in clinical chemistry for cardiovascular risk biomarkers.
• Analysis of analytical quality, metrology, and traceability.
• Evaluation of biological variation and reference change values.

Main Results:

• Analytical quality is satisfactory for total cholesterol, triglycerides, glucose, and HbA1c.
• Improvements are required for HDL-cholesterol, LDL-cholesterol, apolipoprotein A1, apolipoprotein B, Lp(a), and LpPLA2.
• Biological variation significantly affects lipid diagnostics (RCV > 20% for most).
• Current remnant cholesterol measurement methods are suboptimal, requiring standardization.

Conclusions:

• While some cardiovascular risk biomarkers meet quality standards, others require significant improvement.
• Biological variation is a critical consideration in interpreting lipid profiles.
• Standardization of remnant cholesterol measurement is essential for accurate cardiovascular risk assessment.