Role of Biochemical Markers of Cardiovascular Disease in Clinical Practice

Dear Colleagues,

From a global perspective, cardiovascular diseases (CVD) are still the leading cause of morbidity and mortality. Primary and secondary prevention of CVD are public health priorities. Substantial data indicate that CVD is a life course disease that begins with the evolution of risk factors that in turn contribute to the development of subclinical atherosclerosis. Subclinical disease culminates in overt CVD. The onset of CVD itself portends an adverse prognosis with greater risk of recurrent events, morbidity, and mortality. It is also increasingly clear that although clinical assessment is the keystone of patient management, such evaluation has its limitations.9–12 Clinicians have used additional tools to aid clinical assessment and to enhance their ability to identify the “vulnerable” patient at risk for CVD. Biomarkers are one such tool to better identify high-risk individuals, to diagnose disease conditions promptly and accurately, and to effectively prognosticate and treat patients with disease. In the past several years different biomarkers exploring the “Continuum” of CVD have been proposed and clinically validated. In particular cardiac troponin has become the marker of choice for the diagnosis of myocardial infarction and has allowed the reliable detection of clinical and subclinical myocardial injury in many diseases; natriuretic peptides are routinely used for the exclusion of heart failure and for monitoring the progression of the disease and the efficacy of therapeutic interventions. There are however several issues that need to be assessed when biomarkers are proposed for the identification of the “vulnerable” patient. In particular, markers of inflammation and activation of the haemostatic system are still under scrutiny for this purpose. This Special Issue provides an overview of the clinical use of established biomarkers and a perspective on the potential diagnostic and prognostic potential of those biomarkers still not universally validated.

Prof. Dr. Marcello Galvani
Prof. Dr. Allan S. Jaffe
Guest Editors

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• troponin
• natriuretic peptides
• C-reactive protein
• hemostatic markers
• inflammatory markers
• atherosclerosis
• coronary thrombosis