Emerging inflammatory markers for assessing coronary heart disease risk.
Although assessment of traditional coronary heart disease risk factors can often stratify individuals into low- or high-risk categories, additional means are needed to more precisely classify people clinically defined as intermediate-risk, to guide the intensity of risk-reducing therapies. The recognition that inflammatory pathways are important in the progression of atherosclerosis and its complications has prompted investigation to identify circulating risk markers that may be useful in risk stratification. This article summarizes recent studies on the current use of an emerging group of inflammatory markers: soluble CD-40 ligand, interleukin-18, myeloperoxidase, B-type natriuretic peptides, secretory phospholipase A(2), lipoprotein-associated phospholipase A(2), and C-reactive protein. The demonstration that lowering C-reactive protein along with low-density lipoprotein cholesterol with statins reduces events beyond cholesterol lowering alone suggests that titration of therapies using other emerging inflammatory markers may further reduce the toll of atherosclerosis in adult populations.
University of Washington School of Medicine, Cardiology Section Chief, Harborview Medical Center, Room 2CT-64, Box 359748, 325 Ninth Avenue, Seattle, WA 98104, USA. mcorson@u.washington.edu
Marshall A
MA
Corson
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D023201:CD40 Ligand / Q000378:metabolism; D008078:Cholesterol, LDL / Q000187:drug effects / Q000378:metabolism; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology*; D020382:Interleukin-18 / Q000378:metabolism; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D009195:Peroxidase / Q000378:metabolism; D054497:Phospholipases A2, Secretory / Q000378:metabolism; D018570:Risk Assessment; D012307:Risk Factors
D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D020382:Interleukin-18; D020097:Natriuretic Peptide, Brain; D023201:CD40 Ligand; D002097:C-Reactive Protein; D009195:Peroxidase; D054497:Phospholipases A2, Secretory; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase