Department of Internal Medicine and Medical Specialties-DIMIS, University of Palermo, Palermo, Italy.
Intern Emerg Med. 2012 Oct;7 Suppl 3:S263-70. doi: 10.1007/s11739-012-0830-9.
Over the past few decades, a number of coronary artery disease (CAD) and cardiovascular disease (CVD) risk factors have been identified. The predictive power of "conventional" risk factors have been validated by observational, prospective and intervention studies. Nevertheless, all attempts to exactly predict the individual risk for CAD have failed, biased by a large number of incorrectly risk-classified subjects. To improve cardiovascular (CV) risk prediction, a large number of genetic and/or non-genetic biomarkers have been discovered and tested against the "classical" risk factors for their power to predict CV risk. Only few of them had a significant improvement over the predictive models. In this paper, the most investigated biomarkers will be discussed and the evidence of their use as predictors of CV will be questioned.
在过去的几十年中,已经确定了许多冠心病 (CAD) 和心血管疾病 (CVD) 的风险因素。观察性、前瞻性和干预性研究已经验证了“传统”风险因素的预测能力。然而,所有试图准确预测 CAD 个体风险的尝试都失败了,这是由于大量错误的风险分类受试者造成的。为了提高心血管 (CV) 风险预测,已经发现了大量遗传和/或非遗传生物标志物,并针对“经典”风险因素对其预测 CV 风险的能力进行了测试。其中只有少数几个在预测模型方面有显著的提高。本文将讨论研究最多的生物标志物,并对其作为 CV 预测因子的应用证据提出质疑。