The Use of Blood Biomarkers in Precision Medicine for the Primary Prevention of Atherosclerotic Cardiovascular Disease: a Review.

IF 1 Q4 PHARMACOLOGY & PHARMACY
Ty Sweeney, Renato Quispe, Thomas Das, Stephen P Juraschek, Seth S Martin, Erin D Michos
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引用次数: 10

Abstract

Introduction: A biomarker is a substance, structure, or process that indicates the presence of a disease, infection, or environmental exposure. Clinically useful biomarkers are measurable, improve diagnostic or prognostic performance, and ultimately aid clinicians in determining the initiation, duration, or magnitude of therapy.

Areas covered: The purpose of this review is to explore the roles of various blood biomarkers of atherosclerotic cardiovascular disease (ASCVD) and how their use may improve the precision with which clinicians can identify, treat, and ultimately prevent ASCVD. Our review will include lipid biomarkers, markers of cardiac injury and wall stress, markers of inflammation, and a few others.

Expert opinion: Several biomarkers have recently been highlighted as "risk-enhancing factors" in the 2019 American College of Cardiology/American Heart Association Guideline for the Primary Prevention of ASCVD, which can help guide shared decision-making. These included elevated low-density lipoprotein cholesterol, triglycerides, lipoprotein(a), apolipoprotein B, or high-sensitivity C-reactive protein. However, some other biomarkers mentioned in this review are not commonly used despite showing initial promise as prognostic of ASCVD risk, as it is not clear how treatment decisions should be changed after their measurement among asymptomatic individuals. Future studies should focus on whether biomarker-directed management strategies can improve clinical outcomes.

血液生物标志物在精准医学中用于动脉粥样硬化性心血管疾病一级预防的研究进展
生物标志物是指示疾病、感染或环境暴露存在的物质、结构或过程。临床上有用的生物标志物是可测量的,可改善诊断或预后表现,并最终帮助临床医生确定治疗的开始、持续时间或程度。涵盖领域:本综述的目的是探讨各种血液生物标志物在动脉粥样硬化性心血管疾病(ASCVD)中的作用,以及它们的使用如何提高临床医生识别、治疗和最终预防ASCVD的准确性。我们的综述将包括脂质生物标志物、心脏损伤和壁应力标志物、炎症标志物和其他一些标志物。专家意见:在2019年美国心脏病学会/美国心脏协会ASCVD一级预防指南中,一些生物标志物最近被强调为“风险增强因素”,可以帮助指导共同决策。包括低密度脂蛋白胆固醇、甘油三酯、脂蛋白(a)、载脂蛋白B或高敏c反应蛋白升高。然而,本综述中提到的其他一些生物标志物尽管最初有望作为ASCVD风险的预后指标,但并未被广泛使用,因为尚不清楚在无症状个体中测量后应如何改变治疗决策。未来的研究应该关注生物标志物导向的管理策略是否能改善临床结果。
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来源期刊
CiteScore
2.30
自引率
0.00%
发文量
9
期刊介绍: Expert Review of Precision Medicine and Drug Development publishes primarily review articles covering the development and clinical application of medicine to be used in a personalized therapy setting; in addition, the journal also publishes original research and commentary-style articles. In an era where medicine is recognizing that a one-size-fits-all approach is not always appropriate, it has become necessary to identify patients responsive to treatments and treat patient populations using a tailored approach. Areas covered include: Development and application of drugs targeted to specific genotypes and populations, as well as advanced diagnostic technologies and significant biomarkers that aid in this. Clinical trials and case studies within personalized therapy and drug development. Screening, prediction and prevention of disease, prediction of adverse events, treatment monitoring, effects of metabolomics and microbiomics on treatment. Secondary population research, genome-wide association studies, disease–gene association studies, personal genome technologies. Ethical and cost–benefit issues, the impact to healthcare and business infrastructure, and regulatory issues.
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