TY - JOUR
T1 - The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation
T2 - Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society
AU - Vlachopoulos, Charalambos
AU - Xaplanteris, Panagiotis
AU - Aboyans, Victor
AU - Brodmann, Marianne
AU - Cífková, Renata
AU - Cosentino, Francesco
AU - De Carlo, Marco
AU - Gallino, Augusto
AU - Landmesser, Ulf
AU - Laurent, Stéphane
AU - Lekakis, John
AU - Mikhailidis, Dimitri P
AU - Naka, Katerina K
AU - Protogerou, Athanasios D
AU - Rizzoni, Damiano
AU - Schmidt-Trucksäss, Arno
AU - Van Bortel, Luc
AU - Weber, Thomas
AU - Yamashina, Akira
AU - Zimlichman, Reuven
AU - Boutouyrie, Pierre
AU - Cockcroft, John
AU - O'Rourke, Michael
AU - Park, Jeong Bae
AU - Schillaci, Giuseppe
AU - Sillesen, Henrik
AU - Townsend, Raymond R
N1 - Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
PY - 2015/8
Y1 - 2015/8
N2 - 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.
AB - 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.
KW - Aging
KW - Ankle Brachial Index
KW - Biomarkers
KW - C-Reactive Protein
KW - Cardiology
KW - Cardiovascular Diseases
KW - Carotid Arteries
KW - Carotid Intima-Media Thickness
KW - Cost-Benefit Analysis
KW - Decision Making
KW - Europe
KW - Hemodynamics
KW - Humans
KW - Primary Prevention
KW - Research Design
KW - Risk
KW - Secondary Prevention
KW - Societies, Medical
KW - Treatment Outcome
KW - Ultrasonography
KW - Vascular Stiffness
U2 - 10.1016/j.atherosclerosis.2015.05.007
DO - 10.1016/j.atherosclerosis.2015.05.007
M3 - Review
C2 - 26117398
VL - 241
SP - 507
EP - 532
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
IS - 2
ER -