Looking to the Future: Spotlight on Emerging Biomarkers for Predicting Cardiovascular Risk
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Purpose of Review
Coronary artery disease (CAD) continues to be a major contributor to death and disability worldwide. Emerging biomarkers that are linked to CAD pathophysiology have the potential to phenotype CAD severity and identify individuals at high risk for experiencing future CAD events. This review discusses the utility of emergent biomarkers for CAD risk prediction.
Monocytes and neutrophils are key effectors of cardiovascular inflammation, and aspects of their biology have recently been associated with cardiovascular risk. In particular, intermediate (Mon2) monocytosis is robustly associated with major adverse cardiovascular events (MACE) and surrogate markers of neutrophil extracellular trap (NET) formation have also emerged as independent predictors of MACE. MicroRNAs (miRNAs) are essential regulators of cardiovascular physiology, and a wealth of data suggests that circulating miRNA levels are linked with risk of future CAD events. A number of studies demonstrate the predictive value of a multi-miRNA panel in assessing risk and this approach is likely to more accurately predict progression of CAD to a clinically overt event, over a single-marker approach.
A number of emerging inflammatory and miRNA biomarkers hold promise for phenotyping an individual’s risk of future CAD events. Research into these particular biomarkers is in its infancy, and independent validation and methodological standardization is now required to facilitate their translation into clinical use. Ultimately, a biomarker-based methodology for identifying a high-risk phenotype will allow for targeted and personalized therapy for CAD prevention.
KeywordsCoronary artery disease Monocytes Neutrophils Inflammation MicroRNAs Prognosis
Compliance with Ethical Standards
Conflict of Interest
K.E.H. reports grants from Wellington Medical Research Foundation, Lottery Health Research, and Victoria University of Wellington, outside the submitted work. K.M.D. declares no conflicts of interest. P.D.L. reports grants from Wellington Medical Research Foundation, Lotteries Health Research, Otago Medical School Research Grant, Dean’s Research Grant University of Otago, and Health Research Council New Zealand, outside the submitted work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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