Inflammatory Markers in Cardiovascular Disease; Lessons Learned and Future Perspectives

Curr Vasc Pharmacol. 2021;19(3):323-342. doi: 10.2174/1570161118666200318104434.

Abstract

Background: Cardiovascular disease (CVD) still remains the leading cause of morbidity and mortality worldwide. It is now established that inflammation plays a crucial role in atherosclerosis and atherothrombosis, and thus, it is closely linked to cardiovascular disease.

Objective: The aim of the present review is to summarize and critically appraise the most relevant evidence regarding the potential use of inflammatory markers in the field of CVD.

Methods: We conducted a comprehensive research of the relevant literature, searching MEDLINE from its inception until November 2018, primarily for meta-analyses, randomized controlled trials and observational studies.

Results: Established markers of inflammation, mainly C-reactive protein, have yielded significant results both for primary and secondary prevention of CVD. Newer markers, such as lipoprotein-associated phospholipase A2, lectin-like oxidized low-density lipoprotein receptor-1, cytokines, myeloperoxidase, cell adhesion molecules, matrix metalloproteinases, and the CD40/CD40 ligand system, have been largely evaluated in human studies, enrolling both individuals from the general population and patients with established CVD. Some markers have yielded conflicting results; however, others are now recognized not only as promising biomarkers of CVD, but also as potential therapeutic targets, establishing the role of anti-inflammatory and pleiotropic drugs in CVD.

Conclusion: There is significant evidence regarding the role of consolidated and novel inflammatory markers in the field of diagnosis and prognosis of CVD. However, multimarker model assessment, validation of cut-off values and cost-effectiveness analyses are required in order for those markers to be integrated into daily clinical practice.

Keywords: Cardiovascular disease; acute ischemic events; atherosclerosis; biomarker; inflammation; therapeutic targets.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / metabolism*
  • Cardiovascular Diseases / mortality
  • Cardiovascular System / drug effects
  • Cardiovascular System / metabolism*
  • Heart Disease Risk Factors
  • Humans
  • Inflammation / diagnosis
  • Inflammation / drug therapy
  • Inflammation / metabolism*
  • Inflammation / mortality
  • Inflammation Mediators / metabolism*
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Risk Assessment
  • Signal Transduction

Substances

  • Anti-Inflammatory Agents
  • Inflammation Mediators