Systematic review on the association between F2-isoprostanes and cardiovascular disease

Background: Oxidative stress may play an aetiological role in the development and progression of cardiovascular disease (CVD). However, evidence on its biochemical markers has been controversial. This article aimed to assess the role of F-2-isoprostanes, a marker for measuring in vivo lipid oxidation, as a biomarker for CVD, including coronary artery disease, stroke and peripheral artery disease. Methods: A literature search was performed using PubMed and EMBASE (from 1966 to February 2012). Studies that investigated the association between F-2-isoprostanes and CVD were eligible. Results: Of the 22 eligible studies retrieved, 20 studies showed a significant association between F-2-isoprostanes and CVD. However, to date, there have been only four population-based studies, with one study reporting null association. Although data from prospective studies are ideal to examine a role of such biomarkers in predicting future CVD events, only two studies were prospective. In addition, differences in population characteristics, sample handling/storage and assays, coupled with a lack of confounding adjustment, may all contribute to the enormous variation in previous studies. Conclusions: High levels of F-2-isoprostanes in urine or blood may be a non-specific indicator of CVD. However, further population-based studies are needed. In addition, multivariable analyses are required for future studies to control confounding and improve classification accuracy.