Lipids, Apolipoproteins, and Inflammatory Biomarkers of Cardiovascular Risk: What Have We Learned?

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Clinical Chemistry

Background:

• Cardiovascular diseases (CVD) remain the leading global cause of mortality.
• CVD risk is multifactorial, influenced by nonmodifiable (age, genetics) and modifiable factors.
• Advances in identifying cardiovascular (CV) risk biomarkers and surrogate endpoints have been significant.

Purpose of the Study:

• To review the current knowledge of plasma biomarkers for cardiovascular risk.
• To discuss validated and potential surrogate endpoints for CV outcomes.
• To highlight emerging omics-based biomarkers and their clinical relevance.

Main Methods:

• Comprehensive review of existing literature on plasma biomarkers for CVD.
• Analysis of established biomarkers such as lipids, apolipoproteins, and inflammatory markers.
• Inclusion of emerging biomarkers including genetic risk scores, protein-based scores, and gut microbiota metabolites.

Main Results:

• Plasma low-density lipoprotein-cholesterol reduction is a clinically validated surrogate endpoint.
• Plasma triglyceride reduction is a likely relevant surrogate endpoint for CV outcomes.
• High-density lipoprotein-cholesterol is a useful CV risk biomarker, though not a validated surrogate endpoint.
• Key biomarkers of interest include apolipoprotein B, non-HDL-cholesterol, lipoprotein (a), C-reactive protein, and trimethylamine N-oxide (TMAO).

Conclusions:

• Plasma biomarkers play a crucial role in assessing and managing cardiovascular disease risk.
• Lipid-based markers and inflammatory markers are well-established, with emerging omics-based markers showing promise.
• Continued research into novel biomarkers and surrogate endpoints is essential for improving CV outcome prediction and prevention strategies.