Markers of inflammation and cardiovascular disease application to clinical and public health practice - A statement for healthcare professionals from the centers for disease control and prevention and the American Heart Association
Markers of inflammation and cardiovascular disease application to clinical and public health practice - A statement for healthcare professionals from the centers for disease control and prevention and the American Heart Association
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DOI：
10.1161/01.cir.0000052939.59093.45
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发表时间：
2003-01-28
期刊：
影响因子：
37.8
通讯作者：
Vinicor, F
中科院分区：
文献类型：
--
作者：
Pearson, TA;Mensah, GA;Vinicor, F
1998年，美国心脏协会召开了第五次预防会议，以审查识别需要一级预防的高危患者的策略。在讨论的策略中，有一项是炎症标志物的测量。1会议得出结论，“许多这些标志物（包括炎症标志物）尚未被认为适用于常规风险评估，因为：（1）缺乏测量标准化，（2）前瞻性研究的流行病学结果与终点缺乏一致性，（3）缺乏证据表明新标志物增加了风险预测，超过了通过使用已确定的风险因素已经实现的风险预测。国家胆固醇教育计划成人治疗小组III指南将这些标志物确定为新兴风险因素，1a可用作可选的风险因素测量，以调整使用标准风险因素获得的绝对风险估计值。自这些出版物发表以来，已经发表了大量关于炎症标志物与心血管疾病（CVD）的同行评审科学报告。已经有几种用于炎症标志物的商业测定法。由于不断扩大的研究基础和检测方法的可用性，临床医生订购的用于CVD风险预测的炎症标志物检测的数量迅速增长。尽管如此，专业协会或政府机构尚未就如何在临床实践中使用这些炎症标志物测定达成共识。2002年3月14日和15日，在佐治亚州亚特兰大召开了一个题为“CDC/AHA炎症标志物和心血管疾病研讨会：临床和公共卫生实践应用”的研讨会，以解决这些问题。这次研讨会的目标是确定应使用哪些现有的测试;应使用哪些结果来定义高风险;哪些患者应进行测试;以及测试最有用的适应症。这些决定应有助于临床医生明智和适当地选择测试，并应帮助医疗保健支付者在临床实践中做出有关支持此类测试的决定。
In 1998, the American Heart Association convened Prevention Conference V to examine strategies for the identification of high-risk patients who need primary prevention. Among the strategies discussed was the measurement of markers of inflammation. 1 The Conference concluded that “many of these markers (including inflammatory markers) are not yet considered applicable for routine risk assessment because of:(1) lack of measurement standardization,(2) lack of consistency in epidemiological findings from prospective studies with endpoints, and (3) lack of evidence that the novel marker adds to risk prediction over and above that already achievable through the use of established risk factors.” The National Cholesterol Education Program Adult Treatment Panel III Guidelines identified these markers as emerging risk factors, 1a which could be used as an optional risk factor measurement to adjust estimates of absolute risk obtained using standard risk factors. Since these publications, a large number of peer-reviewed scientific reports have been published relating inflammatory markers to cardiovascular disease (CVD). Several commercial assays for inflammatory markers have become available. As a consequence of the expanding research base and availability of assays, the number of inflammatory marker tests ordered by clinicians for CVD risk prediction has grown rapidly. Despite this, there has been no consensus from professional societies or governmental agencies as to how these assays of markers of inflammation should be used in clinical practice. On March 14 and 15, 2002, a workshop titled “CDC/AHA Workshop on Inflammatory Markers and Cardiovascular Disease: Applications to Clinical and Public Health Practice” was convened in Atlanta, Ga, to address these issues. The goals of this workshop were to determine which of the currently available tests should be used; what results should be used to define high risk; which patients should be tested; and the indications for which the tests would be most useful. These determinations should assist the clinician in selecting tests judiciously and appropriately and should assist healthcare payers in making decisions about the support of such tests in clinical practice.