Biomarkers of outcome from cardiovascular disease.
OBJECTIVE
Recognition of the fact that low-grade local and systemic inflammation accompanies all stages of atherogenesis has led to the identification of a number of novel biomarkers of cardiovascular risk. We highlight recent epidemiological and experimental evidence concerning four emerging biomarkers: C-reactive protein, interleukin-6, D-dimer and white blood cell count.


RESULTS
Recent epidemiological and experimental data on C-reactive protein, the most extensively studied marker of systemic inflammation, produced in the liver in response to interleukin-6, has cast some doubt on its clinical utility and causal involvement in atherogenesis. However, a large number of studies still strongly support C-reactive protein as an independent predictor of future cardiovascular risk and a potent proatherogenic agent. Among all markers of inflammation studied to date, C-reactive protein seems the most suitable one for use in clinical practice. Regarding white blood cell count, recent studies focused on the differential leucocyte count in coronary-heart-disease risk assessment; neutrophil count represents the strongest predictor of incident coronary heart disease.


CONCLUSIONS
Thus, screening for low-grade inflammation using several novel biomarkers might provide an important tool to identify individuals at increased risk who would benefit most from targeted preventive interventions.
Khuseyinova
Natalie
N
Department of Internal Medicine II - Cardiology, University of Ulm Medical Center, Ulm, Germany.
Koenig
Wolfgang
W
D050197:Atherosclerosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008403:Mass Screening
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; C036309:fibrin fragment D; D002097:C-Reactive Protein