Novel and Emerging Biomarkers for Cardiovascular Risk Stratification: Role of Inflammatory and Other Biomarkers

Apart from the use of cardiac biomarker for diagnosing and monitoring Acute ischemic disease, an
acute myocardial infarction (AMI) and Heart failure, the same biomarkers can also be used for
predicting the chances of suffering from these diseases in future. In a way these can be used as
screening biomarkers. Since the biomarkers, which are intracellular biomolecules, are released in to
the peripheral circulation from necrosis of myocytes. Lipids and lipoproteins do have high value in
assessing the risk of future cardiac disease, but are not produced by the heart and don't directly
reflect the status of the heart, rather they simply provide a measurement of future risk of
atherosclerosis. Cardiac biomarkers on the other hand can also provide or help in assesing the extent
of damage that has been caused to the myocardium because of their specificity and rapid release or
increase in the peripheral blood post injury to the myocardium, as well as their presence in plasma in
low concentrations normally. Hence other than the classic cardiovascular risk markers like LDL-C,
HDL-C, and triglycerides, presence in abnormal amounts of the emerging markers like apolipoprotein
A1/apolipoprotein B100, Lp(a), oxidized LDL, LpPLA2, hsCRP, homocysteine, myeloperoxidase and
as well as lipoprotein particle size and concentration can indicate, as well as predict myocardial
stress more accurately. The probability of developing a cardiac disease is higher if a particular risk
marker is in abnormal amounts. Inflammatory markers predict MI and death. Some others predict the
risk of acute coronary syndrome, incident and recurrent cardiovascular events. All the merging
biomarkers have all been well validated to predict death and heart failure following a MI and provide
risk stratification information for heart failure. Rapidly developing new areas, such as assessment of
micro-RNA, are also explored. All the biomarkers reflect different aspects of the development of
atherosclerosis. This, in no way means that the individual is certain to develop cardiac disease but is
most likely to get the disease.