期刊
ATHEROSCLEROSIS
卷 241, 期 2, 页码 507-532出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2015.05.007
关键词
Vascular biomarkers; Carotid ultrasonography; Ankle-brachial index; Arterial stiffness; Central haemodynamics; Wave reflections; Endothelial function; Circulating biomarkers
资金
- Abbott Vascular
- Medtronic
- MSD
- AstraZeneca
- Libytec
- Merck
- GSK
- Janssen
- Actogenix
- Menarini
- Yakult
- Elsevier
- i.e.m. Stolberg Germany
- Atcor Medical
- Alam Medical
- Esaote
- Novartis
While risk scores are invaluable tools for adapted preventive strategies, a significant gap exists between predicted and actual event rates. Additional tools to further stratify the risk of patients at an individual level are biomarkers. A surrogate endpoint is a biomarker that is intended as a substitute for a clinical endpoint. In order to be considered as a surrogate endpoint of cardiovascular events, a biomarker should satisfy several criteria, such as proof of concept, prospective validation, incremental value, clinical utility, clinical outcomes, cost-effectiveness, ease of use, methodological consensus, and reference values. We scrutinized the role of peripheral (i.e. not related to coronary circulation) noninvasive vascular biomarkers for primary and secondary cardiovascular disease prevention. Most of the biomarkers examined fit within the concept of early vascular aging. Biomarkers that fulfill most of the criteria and, therefore, are close to being considered a clinical surrogate endpoint are carotid ultrasonography, ankle-brachial index and carotid-femoral pulse wave velocity; biomarkers that fulfill some, but not all of the criteria are brachial ankle pulse wave velocity, central haemodynamics/wave reflections and C-reactive protein; biomarkers that do no not at present fulfill essential criteria are flow-mediated dilation, endothelial peripheral arterial tonometry, oxidized LDL and dysfunctional HDL. Nevertheless, it is still unclear whether a specific vascular biomarker is overly superior. A prospective study in which all vascular biomarkers are measured is still lacking. In selected cases, the combined assessment of more than one biomarker may be required. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.
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