J Lipid Atheroscler.  2019 Sep;8(2):173-182. 10.12997/jla.2019.8.2.173.

The Potential Role of Biomarkers Associated with ASCVD Risk: Risk-Enhancing Biomarkers

Affiliations
  • 1Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University, College of Medicine, Seoul, Korea. heartcsh@gmail.com

Abstract

Serum cholesterol is major risk factor and contributor to atherosclerotic cardiovascular disease (ASCVD). Therapeutic cholesterol-lowering drugs, especially statin, revealed that reduction in low-density lipoprotein cholesterol (LDL-C) produces marked reduction of ASCVD events. In the preventive scope, lower LDL-C is generally accepted as better in proven ASCVD patients and high-risk patient groups. However, in patients with low to intermediate risk without ASCVD, risk assessment is clinically guided by traditional major risk factors. In this group, the complement approach to detailed risk assessment about traditional major risk factors is needed. These non-traditional risk factors include ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, lipoprotein(a) (Lp[a]), apolipoprotein B (apoB), or coronary artery calcium (CAC) score. CAC measurements have an additive role in the decision to use statin therapy in non-diabetic patients 40-75 years old with intermediate risk in primary prevention. This review comprises ASCVD lipid/biomarkers other than CAC. The 2013 and 2018 American College of Cardiology/American Heart Association (ACC/AHA) guidelines suggest these factors as risk-enhancing factors to help health care providers better determine individualized risk and treatment options especially regarding abnormal biomarkers. The recent 2018 Korean guidelines for management of dyslipidemia did not include these biomarkers in clinical decision making. The current review describes the current roles of hsCRP, ABI, LP(a), and apoB in personal modulation and management of health based on the 2018 ACC/AHA guideline on the management of blood cholesterol.

Keyword

Cardiovascular disease; Risk assessment; Biomarkers; Statins

MeSH Terms

Ankle Brachial Index
Apolipoproteins
Apolipoproteins B
Biomarkers*
C-Reactive Protein
Calcium
Cardiovascular Diseases
Cholesterol
Clinical Decision-Making
Complement System Proteins
Coronary Vessels
Dyslipidemias
Health Personnel
Heart
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoprotein(a)
Lipoproteins
Primary Prevention
Risk Assessment
Risk Factors
Apolipoproteins
Apolipoproteins B
Biomarkers
C-Reactive Protein
Calcium
Cholesterol
Complement System Proteins
Lipoprotein(a)
Lipoproteins
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