Biomarkers as a Guide of Medical Treatment in Cardiovascular Diseases

M.      Vavuranakis; M.      G. Kariori; K.      I. Kalogeras; D.      A. Vrachatis; C.      Moldovan; D.      Tousoulis; C.      Stefanadis

Abstract

There is increasing interest in utilizing novel markers of cardiovascular disease risk and consequently, there is a need to assess the value of their use. In this paper, we will review the role of biomarkers in acute coronary syndromes, heart failure and risk stratification for cardiovascular events as guide for treatment scribing. In particular, high sensitivity assays for troponin evaluation detect with greater precision patients with elevated troponin. Therefore, direct and appropriate management is succeeded in these patients with reduction of complications due to earlier treatment, as well. Regarding heart failure, randomized trials that have evaluated biomarker guided treatment approach have not succeeded in establishing specific results for natriuretic peptides (BNP, NT-proBNP) use in terms of therapy guidance. Apart from them, a variety of novel or already used biomarkers, have been tested by small trials for heart failure management, without however, managing to dominate in every day care. Finally, as far as risk stratification for cardiovascular events is concerned, hsCRP has proved to be a strong but doubted biomarker. Therefore, lifestyle and behavioral modification remain the cornerstone of primary prevention.

Keywords: cTnI, cTnT, BNP, NT-proBNP, hsCRP, cardiovascular disease, coronary syndromes, troponin, biomarker, biological molecules