Montreal Heart Institute, Montreal, Quebec, Canada.
Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
Clin Pharmacol Ther. 2018 Aug;104(2):244-256. doi: 10.1002/cpt.1114. Epub 2018 Jun 27.
Cardiovascular diseases (CVD) are the first cause of death in the world. CVD risk is influenced by multiple factors, some nonmodifiable such as age, sex, and genetic background, and others modifiable. Great progress has been made over the last decades in the identification of biomarkers of incident or recurrent CV risk and surrogate endpoints of CV outcomes. We present the current state of knowledge for CV biomarkers in plasma including lipids, apolipoproteins, inflammation-related, and emerging omics-based biomarkers. Clinically validated surrogate endpoints for CV outcomes include plasma low-density lipoprotein-cholesterol reduction, and plasma triglyceride reduction is a likely relevant surrogate endpoint. High-density lipoprotein-cholesterol is not a validated surrogate endpoint, but is a useful biomarker of CV risk. CV risk biomarkers of interest include apolipoprotein B and non-HDL-cholesterol, lipoprotein (a), C-reactive protein, and recently, genetic and protein-based risk scores and gut microbiota-derived trimethylamine oxide levels.
心血管疾病（CVD）是世界上的首要死因。CVD 风险受多种因素影响，其中一些是不可改变的，如年龄、性别和遗传背景，而另一些则是可以改变的。在过去几十年中，人们在识别心血管风险的新发病例或复发的生物标志物以及心血管结局的替代终点方面取得了巨大进展。我们介绍了目前在血浆中包括脂质、载脂蛋白、炎症相关和新兴的基于组学的生物标志物在内的心血管生物标志物的知识现状。已临床验证的心血管结局替代终点包括血浆低密度脂蛋白胆固醇降低，而血浆甘油三酯降低可能是一个相关的替代终点。高密度脂蛋白胆固醇不是已验证的替代终点，但它是心血管风险的有用生物标志物。感兴趣的心血管风险生物标志物包括载脂蛋白 B 和非高密度脂蛋白胆固醇、脂蛋白（a）、C 反应蛋白，以及最近的遗传和基于蛋白质的风险评分和肠道微生物衍生的三甲胺氧化物水平。
