Novel and Emerging Biomarkers for Cardiovascular Risk Stratification: Role of Inflammatory and Other Biomarkers

Apart from the use of cardiac biomarker for diagnosing and monitoring Acute ischemic disease, an acute  myocardial  infarction  (AMI)  and  Heart  failure,  the  same  biomarkers  can  also  be  used  for predicting the  chances of  suffering from  these diseases in future.  In a way these  can be used  as screening biomarkers. Since the biomarkers, which are intracellular biomolecules, are released in to the peripheral circulation from necrosis of myocytes. Lipids and lipoproteins do have high  value in assessing  the  risk  of  future  cardiac  disease,  but  are  not  produced  by  the  heart  and  don’t  directly reflect  the  status  of  the  heart,  rather  they  simply  provide  a  measurement  of  future  risk  of atherosclerosis. Cardiac biomarkers on the other hand can also provide or help in assesing the extent of damage that has been caused to the myocardium because of their specificity and rapid release or increase in the peripheral blood post injury to the myocardium, as well as their presence in plasma in low  concentrations  normally.  Hence  other  than  the  classic  cardiovascular  risk markers like LDL-C, HDL-C, and triglycerides, presence in abnormal amounts of the emerging markers like apolipoprotein A1/apolipoprotein B100, Lp(a), oxidized LDL, LpPLA2,hsCRP, homocysteine, myeloperoxidase and as  well  as  lipoprotein  particle  size  and  concentration  can  indicate,  as  well  as  predict myocardial stress more accurately. The probability of developing a cardiac disease is higher if a particular risk marker is in abnormal amounts. Inflammatory markers predict MI and death. Some others predict the risk  of  acute  coronary  syndrome, incident  and  recurrent  cardiovascular  events.  All  the  merging biomarkers have all been well validated to predict death and heart failure following a MI and provide risk stratification information for heart failure. Rapidly developing new areas, such as assessment of micro-RNA, are also explored.  All the biomarkers reflect different aspects of the  development  of atherosclerosis. This, in no way means that the individual is certain to develop cardiac disease but is most likely to get the disease.

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