Abstract
While the received traditional predictors are still the mainstay in the diagnosis and prognosis of CVD events, increasing studies have focused on exploring the ancillary effect of biomarkers for the aspiring of precision. Under which circumstances, soluble ST2 (sST2), lipoprotein-associated phospholipase A2 (Lp-PLA2), myeloperoxidase (MPO), and procalcitonin (PCT) have recently emerged as promising markers in the field of both acute and chronic cardiovascular diseases. Existent clinical studies have demonstrated the significant associations between these markers with various CVD outcomes, which further verified the potentiality of markers in helping risk stratification and diagnostic and therapeutic work-up of patients. The current review article is aimed at illuminating the applicability of these four novels and often neglected cardiac biomarkers in common clinical scenarios, including acute myocardial infarction, acute heart failure, and chronic heart failure, especially in the emergency department. By thorough classification, combination, and discussion of biomarkers with clinical and instrumental evaluation, we hope the current study can provide insights into biomarkers and draw more attention to their importance.
Highlights
Cardiovascular disease (CVD), a major global disease burden, is the leading cause of death and disability worldwide [1]
There are validated biomarkers used at present, for example, troponin which possesses high specificity and Disease Markers sensitivity when diagnosing acute myocardial infarction and BNP/NT-proBNP which is used to assess the severity of heart failure
A prospective population-based Atherosclerosis Risk in Communities (ARIC) cohort study, after 9.6 years of the follow-up study, found that no significant association between intracellular monocyte MPO level and incident of cardiovascular events was found among 1465 patients without a history of peripheral artery disease (PAD), myocardial infarction, or heart failure [60]
Summary
Cardiovascular disease (CVD), a major global disease burden, is the leading cause of death and disability worldwide [1]. The treatment of CVD has made gratifying progress, traditional biomarkers inevitably have the problem of residual risk omission in the screening of high-risk groups and accurate diagnosis, management, and prognosis of the disease. For this reason, the studies of novel biomarkers are becoming the main task. This article reviews four novel cardiac biomarkers which are very significant but have not been used routinely in clinical practice. These biomarkers can be expected for future application in clinical practice
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