Second Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece.
Cardiology Department, KAT Hospital, Athens, Greece.
Curr Vasc Pharmacol. 2021;19(3):323-342. doi: 10.2174/1570161118666200318104434.
Cardiovascular disease (CVD) still remains the leading cause of morbidity and mortality worldwide. It is now established that inflammation plays a crucial role in atherosclerosis and atherothrombosis, and thus, it is closely linked to cardiovascular disease.
The aim of the present review is to summarize and critically appraise the most relevant evidence regarding the potential use of inflammatory markers in the field of CVD.
We conducted a comprehensive research of the relevant literature, searching MEDLINE from its inception until November 2018, primarily for meta-analyses, randomized controlled trials and observational studies.
Established markers of inflammation, mainly C-reactive protein, have yielded significant results both for primary and secondary prevention of CVD. Newer markers, such as lipoprotein-associated phospholipase A2, lectin-like oxidized low-density lipoprotein receptor-1, cytokines, myeloperoxidase, cell adhesion molecules, matrix metalloproteinases, and the CD40/CD40 ligand system, have been largely evaluated in human studies, enrolling both individuals from the general population and patients with established CVD. Some markers have yielded conflicting results; however, others are now recognized not only as promising biomarkers of CVD, but also as potential therapeutic targets, establishing the role of anti-inflammatory and pleiotropic drugs in CVD.
There is significant evidence regarding the role of consolidated and novel inflammatory markers in the field of diagnosis and prognosis of CVD. However, multimarker model assessment, validation of cut-off values and cost-effectiveness analyses are required in order for those markers to be integrated into daily clinical practice.
心血管疾病（CVD）仍然是全球发病率和死亡率的主要原因。现在已经确定，炎症在动脉粥样硬化和动脉血栓形成中起着至关重要的作用，因此与心血管疾病密切相关。
本综述的目的是总结和批判性评价关于炎症标志物在 CVD 领域潜在应用的最相关证据。
我们对相关文献进行了全面研究，主要在 MEDLINE 上进行了搜索，从其开始到 2018 年 11 月，主要是针对荟萃分析、随机对照试验和观察性研究。
炎症的既定标志物，主要是 C 反应蛋白，在 CVD 的一级和二级预防中都取得了显著的结果。一些新的标志物，如脂蛋白相关磷脂酶 A2、凝集素样氧化低密度脂蛋白受体-1、细胞因子、髓过氧化物酶、细胞黏附分子、基质金属蛋白酶和 CD40/CD40 配体系统，已经在人类研究中进行了广泛评估，包括来自普通人群的个体和已确诊 CVD 的患者。一些标志物的结果存在争议；然而，其他标志物现在不仅被认为是 CVD 的有前途的生物标志物，而且被认为是潜在的治疗靶点，确立了抗炎和多效性药物在 CVD 中的作用。
关于既定和新型炎症标志物在 CVD 的诊断和预后领域的作用，有大量证据。然而，需要进行多标志物模型评估、临界值验证和成本效益分析，以便将这些标志物纳入日常临床实践。
