New cardiovascular risk factors exist, but are they clinically useful?
New cardiovascular risk factors exist, but are they clinically useful?
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存在新的心血管危险因素，但它们在临床上有用吗？
DOI：
10.1093/eurheartj/ehm644
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发表时间：
2008
影响因子：
39.3
通讯作者：
Wang,ThomasJ
中科院分区：
文献类型：
--
作者：
Wang,ThomasJ
人们对确定心血管疾病的新风险因素有很大的兴趣，以提高我们对疾病生物学的理解，并解释无法用已知风险因素解释的心脏病病例。推定的危险因素的调查经常涉及循环生物标志物的研究。近年来，人们对这些新措施的有效性和有用性进行了激烈的辩论。对证据的仔细评估表明，大多数较新的生物标志物还没有准备好在一级预防环境中进行常规临床使用。好消息是，传统的风险因素在预测未来心血管风险方面表现得相当好。对“经典”风险因素的认识和控制不足仍然是大量可避免的心血管事件的原因。与此同时，对疾病机制的新见解应该会导致新的预防性治疗的发展，无论生物标志物本身在风险分层中的表现如何。此外，允许对大组基因、转录物、蛋白质或小分子进行分析的最新技术应该有助于发现能够提供机制见解和真正预后效用的更新的生物标志物。
There is substantial interest in identifying new risk factors for cardiovascular disease, to improve our understanding of disease biology and to account for the cases of heart disease that cannot be explained by known risk factors. Investigation of putative risk factors frequently involves the study of circulating biomarkers. In recent years, a spirited debate has arisen regarding the validity and usefulness of these new measures. A careful assessment of the evidence suggests that most newer biomarkers are not ready for routine clinical use in the primary prevention setting. The good news is that traditional risk factors perform quite well with regard to the prediction of future cardiovascular risk. Inadequate recognition and control of the ‘classic’ risk factors continues to account for a large number of avoidable cardiovascular events. At the same time, new insights into disease mechanisms should lead to the development of novel preventive therapies, regardless of how well biomarkers themselves perform in risk stratification. Furthermore, state-of-the-art technologies that allow the profiling of large panels of genes, transcripts, proteins, or small molecules should facilitate the discovery of newer biomarkers capable of providing both mechanistic insight and true prognostic utility.