The Potential Role of Biomarkers Associated with ASCVD Risk: Risk-Enhancing Biomarkers
10.12997/jla.2019.8.2.173
- Author:
Seonghoon CHOI
1
Author Information
1. Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Korea. heartcsh@gmail.com
- Publication Type:Review
- Keywords:
Cardiovascular disease;
Risk assessment;
Biomarkers;
Statins
- MeSH:
Ankle Brachial Index;
Apolipoproteins;
Apolipoproteins B;
Biomarkers;
C-Reactive Protein;
Calcium;
Cardiovascular Diseases;
Cholesterol;
Clinical Decision-Making;
Complement System Proteins;
Coronary Vessels;
Dyslipidemias;
Health Personnel;
Heart;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Lipoprotein(a);
Lipoproteins;
Primary Prevention;
Risk Assessment;
Risk Factors
- From:Journal of Lipid and Atherosclerosis
2019;8(2):173-182
- CountryRepublic of Korea
- Language:English
-
Abstract:
Serum cholesterol is major risk factor and contributor to atherosclerotic cardiovascular disease (ASCVD). Therapeutic cholesterol-lowering drugs, especially statin, revealed that reduction in low-density lipoprotein cholesterol (LDL-C) produces marked reduction of ASCVD events. In the preventive scope, lower LDL-C is generally accepted as better in proven ASCVD patients and high-risk patient groups. However, in patients with low to intermediate risk without ASCVD, risk assessment is clinically guided by traditional major risk factors. In this group, the complement approach to detailed risk assessment about traditional major risk factors is needed. These non-traditional risk factors include ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, lipoprotein(a) (Lp[a]), apolipoprotein B (apoB), or coronary artery calcium (CAC) score. CAC measurements have an additive role in the decision to use statin therapy in non-diabetic patients 40–75 years old with intermediate risk in primary prevention. This review comprises ASCVD lipid/biomarkers other than CAC. The 2013 and 2018 American College of Cardiology/American Heart Association (ACC/AHA) guidelines suggest these factors as risk-enhancing factors to help health care providers better determine individualized risk and treatment options especially regarding abnormal biomarkers. The recent 2018 Korean guidelines for management of dyslipidemia did not include these biomarkers in clinical decision making. The current review describes the current roles of hsCRP, ABI, LP(a), and apoB in personal modulation and management of health based on the 2018 ACC/AHA guideline on the management of blood cholesterol.
