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血液生物标志物在心血管疾病风险预测中作用的叙述性综述

A Narrative Review of the Role of Blood Biomarkers in the Risk Prediction of Cardiovascular Diseases.

作者信息

Garady Lavanya, Soota Ashok, Shouche Yogesh, Chandrachari Komal Prasad, K V Srikanth, Shankar Prasan, Sharma Sanketh V, C Kavyashree, Munnyal Shrutika, Gopi Ahalya, Devyani Azad

机构信息

Public Health Sciences, Scientific Knowledge for Ageing and Neurological Ailments (SKAN) Research Trust, Bengaluru, IND.

Information Technology, Scientific Knowledge for Ageing and Neurological Ailments (SKAN) Research Trust, Bengaluru, IND.

出版信息

Cureus. 2024 Dec 1;16(12):e74899. doi: 10.7759/cureus.74899. eCollection 2024 Dec.

Abstract

Cardiovascular disease (CVD) is a global health crisis and a leading cause of morbidities and mortalities. Biomarkers whose evaluation would allow the detection of CVD at an early stage of development are actively sought. Biomarkers are objectively measured as indicators of health, disease, or response to an exposure or intervention, including therapeutic interventions. Hence, this review aims to identify biomarkers that can help predict CVD risk in the healthy population. This helps with risk prediction and is crucial for advancing preventive cardiology and improving clinical outcomes in a wide range of patient populations. Biomarkers such as atherogenic lipoproteins, fibrinogen, homocysteine, and thyroid-stimulating hormone (TSH) have been linked to CVD risk factors, including dyslipidemia, hypertension, diabetes, and obesity. When combined with conventional biomarkers, inflammatory markers such as C-reactive protein (CRP) can enhance risk prediction. However, biomarkers such as high-sensitivity troponin T (hsTnT) and N-terminal proBNP (NT-proBNP) are widely used as diagnostic biomarkers for heart failure (HF) and cardiac dysfunction, as they are released only after one to two hours of cardiovascular event occurrence. Myeloperoxidase (MPO) and procalcitonin (PCT) have developed into promising new biomarkers for the early detection of systemic bacterial infections as inflammatory markers, which are better diagnostic tools than screening. Combining biomarkers can improve test accuracy, but the best combinations for diagnosis or prognosis must be identified.

摘要

心血管疾病(CVD)是一场全球健康危机,也是发病和死亡的主要原因。人们正在积极寻找那些能够在心血管疾病发展的早期阶段通过评估检测出该疾病的生物标志物。生物标志物是对健康、疾病或对暴露或干预(包括治疗干预)的反应进行客观测量的指标。因此,本综述旨在识别有助于预测健康人群心血管疾病风险的生物标志物。这有助于风险预测,对于推进预防心脏病学以及改善广泛患者群体的临床结局至关重要。诸如致动脉粥样硬化脂蛋白、纤维蛋白原、同型半胱氨酸和促甲状腺激素(TSH)等生物标志物已与心血管疾病风险因素相关联,这些风险因素包括血脂异常症、高血压、糖尿病和肥胖症。当与传统生物标志物结合使用时,诸如C反应蛋白(CRP)等炎症标志物可以增强风险预测。然而,诸如高敏肌钙蛋白T(hsTnT)和N末端脑钠肽前体(NT-proBNP)等生物标志物被广泛用作心力衰竭(HF)和心脏功能障碍的诊断生物标志物,因为它们仅在心血管事件发生一到两小时后才会释放。髓过氧化物酶(MPO)和降钙素原(PCT)已发展成为用于早期检测全身性细菌感染的有前景的新型生物标志物,作为炎症标志物,它们比筛查是更好的诊断工具。联合使用生物标志物可以提高检测准确性,但必须确定用于诊断或预后的最佳组合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fab2/11688159/96f600f07219/cureus-0016-00000074899-i01.jpg

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