Circulation. 2006;113:2335-2362
doi: 10.1161/CIRCULATIONAHA.104.482570
doi: 10.1161/CIRCULATIONAHA.104.482570
(Circulation. 2006;113:2335-2362.)
© 2006 American Heart Association, Inc.
Basic Science for Clinicians |
Biomarkers of Cardiovascular Disease
Molecular Basis and Practical Considerations
From the National Heart, Lung, and Blood Institute’s Framingham Heart Study, and the Cardiology Section and Department of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Mass.
Correspondence to Ramachandran S. Vasan, MD, Framingham Heart Study, 73 Mount Wayte Ave, Suite 2, Framingham, MA 01702-5803. E-mail vasan@bu.edu
Key Words: atherosclerosis • epidemiology • genetics • genomics • proteins
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in the United States.1 Primary prevention and secondary prevention of CVD are public health priorities.2 Substantial data indicate that CVD is a life course disease that begins with the evolution of risk factors that in turn contribute to the development of subclinical atherosclerosis.3,4 Subclinical disease culminates in overt CVD.5,6 The onset of CVD itself portends an adverse prognosis with greater risk of recurrent events, morbidity, and mortality.7,8 It is also increasingly clear that although clinical assessment is the keystone of patient management, such evaluation has its limitations.9–12 Clinicians have used additional tools to aid clinical assessment and to enhance their ability to identify the "vulnerable" patient at risk for CVD, as suggested by a recent National Institutes of Health (NIH) panel.13,14 Biomarkers are one such tool to better identify high-risk individuals, to diagnose disease conditions promptly and accurately, and to effectively prognosticate and treat patients with disease. This review provides an overview of the molecular basis of biomarker discovery and selection and the practical considerations that are a prerequisite to their clinical use.
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What Is a Biomarker? Definition and Types |
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The term biomarker (biological marker) was introduced in 1989 as a Medical Subject Heading (MeSH) term: "measurable and quantifiable biological parameters (eg, specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy,
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