There are many peer-reviewed papers covering biomarkers in cardiovascular disease, and it is frequently difficult for healthcare professionals to keep up with the literature. As a special service to our readers, CLI presents a few key abstracts from the clinical and scientific literature chosen be our editorial board as being particularly worthy of attention
Fibulin-1 is a marker for arterial extracellular matrix alterations in Type 2 diabetes.
Extracellular matrix alterations are important elements in the arterial changes seen in diabetes, being associated with increased vascular stiffness and the development of cardiovascular diseases. However, no biomarkers for diabetes-related arterial changes have been defined. In this study mammary artery specimens from 17 men with type 2 diabetes and 18 nondiabetic individuals were used for microarray expression profiling, quantitative real-time PCR, immunoassay and immunohistochemical analyses. A derived candidate marker, fibulin-1, an elastin-associated matrix molecule, was measured immunochemically in plasma from (a) 70 patients scheduled for vascular surgery, (b) 305 patients with type 2 diabetes examined with carotid ultrasonography and echocardiography, and (c) 308 patients with type 2 diabetes, followed for 15 years.
The most upregulated transcript in nonatherosclerotic arterial tissue from patients with type 2 diabetes encoded the extracellular matrix protein, fibulin-1. Higher concentrations of fibulin-1-protein were present in artery extracts from patients with diabetes than extracts from individuals without diabetes, and increased fibulin-1 immunostaining was apparent around the external elastic lamina of diabetic arteries. Patients with diabetes displayed increased plasma concentrations of fibulin-1 (P = 0.006). Plasma fibulin-1 concentrations correlated with HbA1C (P < 0.001), arterial stiffness indices including pulse pressure (P < 0.001), and carotid compliance (P = 0.004), as well as plasma N-terminal pro-B-type natriuretic peptide concentrations (P < 0.001) and were predictive of 15-year mortality (P = 0.013).
Fibulin-1 accumulates in the arterial wall and in plasma of patients with type 2 diabetes, and appears to be a factor associated with arterial extracellular matrix changes in type 2 diabetes.
Cangemi C et al. Clin Chem 2011 Sep 16.
Soluble lectin-Like oxidised LDL receptor-1 and high-sensitivity troponin T as diagnostic biomarkers for acute coronary syndrome.
Although highly sensitive assays for troponin T (hs-TnT) have been developed, the sensitivity and specificity of hs-TnT for diagnosing acute coronary syndrome (ACS) remains imperfect. This study evaluated the diagnostic value of a new biomarker of plaque vulnerability (soluble lectin-like oxidised low-density lipoprotein receptor-1, sLOX-1) as compared with hs-TnT in the emergency room.
Plasma sLOX-1 and serum hs-TnT levels were measured in 200 consecutive patients presenting with chest symptoms and ECG abnormalities in the ER (116 ST elevation ACS [STEACS], 44 non-ST elevation ACS [NSTEACS], 40 non-ACS). The non-ACS group consisted of patients with cardiovascular diseases such as coronary spastic angina pectoris, pulmonary thromboembolism, perimyocarditis and takotsubo cardiomyopathy. Levels of sLOX-1 and hs-TnT were significantly higher in STEACS and NSTEACS than in non-ACS patients. The ROC curves of sLOX-1 and hs-TnT for detecting ACS, using the non-ACS patients as negative references, showed that the AUC values of sLOX-1 and hs-TnT were 0.769 and 0.739, respectively. In the lower hs-TnT (<0.0205ng/mL) subgroup, the AUC value of the ROC curve of sLOX-1 for detecting ACS was 0.869.
The diagnostic value for ACS was comparable between sLOX-1 and hs-TnT, and the accuracy of ACS diagnosis appeared to improve when sLOX-1 and hs-TnT were measured in combination
Kobayashi N et al.Circ J. 2011 Sep 21.
Heat-shock proteins in cardiovascular disease.
Heat-shock proteins (HSPs) belong to a group of highly conserved families of proteins expressed by all cells and organisms, and their expression may be constitutive or inducible. They are generally considered as protective molecules against different types of stress and have numerous intracellular functions. Secretion or release of HSPs has also been described, and potential roles for extracellular HSPs reported. HSP expression is modulated by different stimuli involved in all steps of atherogenesis including oxidative stress, proteolytic aggression, or inflammation. In addition antibodies to HSPs may be used to monitor the response to different types of stress that are able to induce changes in HSP levels. This review article focuses on the potential implication of HSPs in atherogenesis and discusses the limitations to the use of HSPs and anti-HSPs as biomarkers of atherothrombosis. HSPs could also be considered as potential therapeutic targets to reinforce vascular defenses and delay or avoid the clinical complications associated with atherothrombosis
Madrigal-Matute J et al. Adv Clin Chem. 2011;54:1-43.
