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Identification of subjects at increased risk for cardiovascular events plays a central role in the worldwide efforts to improve prevention, prediction, diagnosis, and prognosis of cardiovascular disease and to decrease the related costs. Despite their high predictive value on population level, traditional risk factors fail to fully predict individual risk. This position paper provides a summary of current vascular biomarkers other than the traditional risk factors with a special focus on the emerging -omics technologies. The definition of biomarkers and the identification and use of classical biomarkers are introduced, and we discuss the limitations of current biomarkers such as high sensitivity C-reactive protein (hsCRP) or N-terminal pro-brain natriuretic peptide (NT-proBNP). This is complemented by circulating plasma biomarkers, including high-density lipoprotein (HDL), and the conceptual shift from HDL cholesterol levels to HDL composition/function for cardiovascular risk assessment. Novel sources for plasma-derived markers include microparticles, microvesicles, and exosomes and their use for current omics-based analytics. Measurement of circulating micro-RNAs, short RNA sequences regulating gene expression, has attracted major interest in the search for novel biomarkers. Also, mass spectrometry and nuclear magnetic resonance spectroscopy have become key complementary technologies in the search for new biomarkers, such as proteomic searches or identification and quantification of small metabolites including lipids (metabolomics and lipidomics). In particular, pro-inflammatory lipid metabolites have gained much interest in the cardiovascular field. Our consensus statement concludes on leads and needs in biomarker research for the near future to improve individual cardiovascular risk prediction.

Original publication

DOI

10.1093/eurheartj/ehv236

Type

Journal article

Journal

European heart journal

Publication Date

10/2015

Volume

36

Pages

2635 - 2642

Addresses

Laboratory of Experimental Cardiology and Laboratory of Clinical Chemistry and Haematology, University Medical Centre Utrecht, Utrecht, Netherlands i.hoefer@umcutrecht.nl sabine.steffens@med.uni-muenchen.de.

Keywords

ESC Working Group Atherosclerosis and Vascular Biology, Humans, Coronary Disease, Lipoproteins, HDL, MicroRNAs, Risk Assessment, Consensus, Proteomics, Systems Biology, Atherosclerosis, Cell-Derived Microparticles, Metabolomics, Chemistry Techniques, Analytical, Biomarkers