Cardiovascular Disease Biomarkers

Cardiovascular Disease Biomarkers

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Description: Paper is about Biomarkers of Cardiovascular Disease, Identification of Cardiovascular Risk Factors, NIH Definition of Biomarker, Why Biomarkers as Surrogate End Points?, Antecedent Biomarkers of Cardiovascular Disease, CRP and Framingham Risk Score, CRP and cholesterol as additive risk factors for CVD, Fibrinogen and CHD, Epidemiology, Isolation of pulative progenitor endothelial cells for angiogenesis, Circulating Endothelial progenitor cells.

 
Author: Jorge Hernán Ramírez (Fellow) | Visits: 2310 | Page Views: 2319
Domain:  Medicine Category: Therapy Subcategory: Cerebrovascular 
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Short URL: https://www.wesrch.com/medical/pdfME1LYYX48FQML
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Contents:
Programa de Medicina Facultad de Ciencias de la Salud
http://www.icesi.edu.co/medicina/

Jorge Hern�n Ram�rez

Biomarkers of Cardiovascular Disease

Jorge Hern�n Ram�rez

Biomarkers of Cardiovascular Disease

Jorge Hern�n Ram�rez

Identification of Cardiovascular Risk Factors

Experimental studies �Cell cultures �Animal models �Clinical trials

Observational studies �Case-control Case control �Cohort (follow up)

Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

NIH Definition of Biomarker

"A characteristic that is objectively measured and A evaluated as an indicator of normal biological processes, processes pathogenic processes or pharmacologic processes, responses to a therapeutic intervention"

NIH Working group 2001
Jorge Hern�n Ram�rez

Why Biomarkers as Surrogate End Points?
7 years

3200
Biom marker

Placebo

(Mortality 6,2%)

200 death

3000 survive
Intervention

3200

100 death
(Mortality 3,1%)

3000 survive 3000 i
Jorge Hern�n Ram�rez

Biomarkers as Surrogate End Points

� Advantage: Gathered in a shorter time frame and with less expense than "hard" end points. � Di d t Disadvantage: R id l confounding if clinical outcome of i t Residual f di li i l t f interest t is influenced by numerous factors (in addition to the surrogate end point). point)

Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Antecedent Biomarkers of Cardiovascular Disease

Classic Biomarkers Classic Biomarkers

� Blood pressure � Cholesterol (LDL HDL ) Cholesterol (LDL HDL ) � Glycemia (diabetic patients) �h hsCRP � Serum amyloid A � Fibrinogen � Cell adhesion molecules � Lipoproteinassociated PLA2 � Homocysteine y � IL1, IL6, IL8, TNF, IL10 � Endothelial progenitor cells � Flow mediated dilation �I i IntimaMedia Thickness M di Thi k

Molecular Molecular Biomarkers Cell as Biomarkers Imaging Biomarkers i k

Jorge Hern�n Ram�rez

Circulation. 2004;110:e572e576
Jorge Hern�n Ram�rez

CRP and Framingham Risk Score

Ridker P, N Engl J Med, 2002. Vol. 347, No. 20
Jorge Hern�n Ram�rez

CRP and cholesterol as additive risk factors for CVD

Ridker P, N Engl J Med, 2002. Vol. 347, No. 20
Jorge Hern�n Ram�rez

Variability of hsCRP in commercial kits

Level 1 Level 2 Level 3 Level 4 Mean Mean, Mean, Mean, Method , mg/L CV % mg/L CV % mg/L CV % mg/L CV % /L CV, % /L CV, % /L CV, % /L CV, % Dade 0.15 4.9 0.49 6.4 1.36 6.8 1.90 5.8 Daiichi 0.17 6.1 0.39 4.5 1.11 1.3 1.70 2.0 Denka 0.17 0 17 5.1 51 0.41 0 41 3.3 33 1.16 1 16 2.2 22 1.88 1 88 2.5 25 DPC 0.12 11.9 0.46 6.4 1.22 6.9 2.04 6.6 Iatron 0.17 3.4 0.50 1.9 1.44 1.1 2.15 3.1 Kamiya 0.31 13.4 0.52 7.0 1.51 2.9 2.31 2.2 Olympus 0.17 44.1 0.50 15.0 1.47 3.2 2.18 5.4 Roche 0.21 7.2 0.45 2.6 1.30 1.2 2.28 0.6 Wako 0.15 10.7 0.49 3.9 1.44 1.0 2.07 1.1

CV indicates coefficient of variation.

Roberts WL, et al. Clin Chem. 2001; 47: 418�425.
Jorge Hern�n Ram�rez

Scirica B. et al. Circulation. 2006;113:21282151.
Jorge Hern�n Ram�rez

Christen WG, et al. Arch Intern Med. 2000; 160: 422�434
Jorge Hern�n Ram�rez

Danesh J, et al. JAMA. 1998; 279: 1477�1482.
Jorge Hern�n Ram�rez

Lipoprotein associated PLA2 predicts 5year cardiovascular mortality

Winkler K, et al. Clinical Chemistry 2007. 53:8
Jorge Hern�n Ram�rez

Lipoprotein associated PLA2 predicts 5year cardiovascular mortality

Winkler K, et al. Clinical Chemistry 2007. 53:8
Jorge Hern�n Ram�rez

Circulation. 2006;114:381387 Ci l i 2006 114 381 387

Jorge Hern�n Ram�rez

Mora M, et al. Circulation. 2006;114:381387
Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Hill JM, et al. N Engl J Med 2003;348:593600.
Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Flow mediated dilation (FMD)
Oclussion O l i 5 minutes (300mmHg)

Endothelium Dependent epe de t Dilation

(EDD)
Nitrates

Endothelium Independent Dilation

(EID) ( )

Jorge Hern�n Ram�rez

Months
Jorge Hern�n Ram�rez

Circulation. 2007;115:23902397
Jorge Hern�n Ram�rez

INTIMAMEDIA THICKNESS (IMT)

Promedio de 12 mediciones

Near Wall Near Wall

Intima Media
1cm 1cm 1cm

Far Wall
Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Jorge Hern�n Ram�rez

Cr�ditos

Biomarkers of Cardiovascular Disease of Cardiovascular Disease

Facultad de Ciencias de la Salud

Programa de Medicina g
Facultad de Ciencias de la Salud
http://www.icesi.edu.co/medicina/
Jorge Hern�n Ram�rez

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