Riesen Walter F
Institut für Klinische Chemie und Hämatologie, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen.
Rev Med Suisse. 2008 Mar 12;4(148):636-8, 640-3.
A large number of novel biomarkers of cardiovascular risk have recently been identified. To be implemented in clinical practice these biomarkers should fulfill certain requirements, such as independance of other risk factors, improvement of the prediction by global risk assessment, and a therapeutic implication (modifiable risk). Some of these new risk markers have shown a clinical importance under certain circumstances (hsCRP, Lp(a), markers of renal insufficiency, or fibrinogen). Among these, only lowering of hsCRP (in addition to the decrease of LDL-cholesterol) by statins has shown a reduction of the risk of cardiovascular events. The use of new biomarkers should be restricted to persons with intermediate global risk since it allows a new risk stratification.
最近已鉴定出大量心血管风险的新型生物标志物。要在临床实践中应用，这些生物标志物应满足某些要求，例如独立于其他风险因素、通过全球风险评估改善预测以及具有治疗意义（可改变的风险）。其中一些新的风险标志物在某些情况下已显示出临床重要性（高敏C反应蛋白、脂蛋白(a)、肾功能不全标志物或纤维蛋白原）。其中，只有他汀类药物降低高敏C反应蛋白（除降低低密度脂蛋白胆固醇外）已显示出心血管事件风险的降低。新生物标志物的使用应仅限于具有中等全球风险的人群，因为它允许进行新的风险分层。
