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The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society
C. Vlachopoulos, P. Xaplanteris, V. Aboyans, M. Brodmann, R. Cífková, F. Cosentino, M. De Carlo, A. Gallino, U. Landmesser, S. Laurent, J. Lekakis, DP. Mikhailidis, KK. Naka, AD. Protogerou, D. Rizzoni, A. Schmidt-Trucksäss, L. Van Bortel, T....
Language English Country Ireland
Document type Journal Article, Review
- MeSH
- Cost-Benefit Analysis MeSH
- Carotid Arteries ultrasonography MeSH
- Biomarkers blood metabolism MeSH
- C-Reactive Protein metabolism MeSH
- Hemodynamics MeSH
- Carotid Intima-Media Thickness MeSH
- Cardiology standards MeSH
- Cardiovascular Diseases blood diagnosis MeSH
- Humans MeSH
- Primary Prevention MeSH
- Risk MeSH
- Decision Making MeSH
- Secondary Prevention MeSH
- Societies, Medical MeSH
- Aging MeSH
- Ankle Brachial Index MeSH
- Vascular Stiffness MeSH
- Ultrasonography MeSH
- Treatment Outcome MeSH
- Research Design MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Europe MeSH
While risk scores are invaluable tools for adapted preventive strategies, a significant gap exists between predicted and actual event rates. Additional tools to further stratify the risk of patients at an individual level are biomarkers. A surrogate endpoint is a biomarker that is intended as a substitute for a clinical endpoint. In order to be considered as a surrogate endpoint of cardiovascular events, a biomarker should satisfy several criteria, such as proof of concept, prospective validation, incremental value, clinical utility, clinical outcomes, cost-effectiveness, ease of use, methodological consensus, and reference values. We scrutinized the role of peripheral (i.e. not related to coronary circulation) noninvasive vascular biomarkers for primary and secondary cardiovascular disease prevention. Most of the biomarkers examined fit within the concept of early vascular aging. Biomarkers that fulfill most of the criteria and, therefore, are close to being considered a clinical surrogate endpoint are carotid ultrasonography, ankle-brachial index and carotid-femoral pulse wave velocity; biomarkers that fulfill some, but not all of the criteria are brachial ankle pulse wave velocity, central haemodynamics/wave reflections and C-reactive protein; biomarkers that do no not at present fulfill essential criteria are flow-mediated dilation, endothelial peripheral arterial tonometry, oxidized LDL and dysfunctional HDL. Nevertheless, it is still unclear whether a specific vascular biomarker is overly superior. A prospective study in which all vascular biomarkers are measured is still lacking. In selected cases, the combined assessment of more than one biomarker may be required.
Cardiology Department Klinikum Wels Grieskirchen Wels Austria
Cardiology Unit Department of Medicine Karolinska University Hospital Solna 171 76 Stockholm Sweden
Clinica Medica Department of Clinical and Experimental Sciences University of Brescia Brescia Italy
Department of Angiology University Hospital Graz 8036 Graz Austria
Department of Cardiology Athens University Medical School Attikon University Hospital Athens Greece
Department of Cardiology Charité Universitätsmedizin Berlin 12203 Berlin Germany
Department of Cardiology Dupuytren University Hospital Limoges France
Department of Cardiology Tokyo Medical University 160 0023 Tokyo Japan
Department of Cardiology University of Ioannina Medical School Ioannina Greece
Department of Cardiology Wales Heart Research Institute Cardiff CF14 4XN United Kingdom
Department of Vascular Surgery Rigshospitalet University of Copenhagen Denmark
Division of Vascular Medicine Ospedale San Giovanni 6500 Bellinzona Switzerland
Heymans Institute of Pharmacology Ghent University 9000 Ghent Belgium
References provided by Crossref.org
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