The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society

doi:10.1016/j.atherosclerosis.2015.05.007

Review

. 2015 Aug;241(2):507-32.

doi: 10.1016/j.atherosclerosis.2015.05.007. Epub 2015 May 16.

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society

Charalambos Vlachopoulos¹, Panagiotis Xaplanteris¹, Victor Aboyans², Marianne Brodmann³, Renata Cífková⁴, Francesco Cosentino⁵, Marco De Carlo⁶, Augusto Gallino⁷, Ulf Landmesser⁸, Stéphane Laurent⁹, John Lekakis¹⁰, Dimitri P Mikhailidis¹¹, Katerina K Naka¹², Athanasios D Protogerou¹³, Damiano Rizzoni¹⁴, Arno Schmidt-Trucksäss¹⁵, Luc Van Bortel¹⁶, Thomas Weber¹⁷, Akira Yamashina¹⁸, Reuven Zimlichman¹⁹, Pierre Boutouyrie²⁰, John Cockcroft²¹, Michael O'Rourke²², Jeong Bae Park²³, Giuseppe Schillaci²⁴, Henrik Sillesen²⁵, Raymond R Townsend²⁶

Affiliations

¹ Peripheral Vessels Unit, 1st Department of Cardiology, Athens University Medical School, Hippokration Hospital, Athens, Greece.
² Department of Cardiology, Dupuytren University Hospital, Limoges, France.
³ Department of Angiology, University Hospital Graz, 8036 Graz, Austria.
⁴ Department of Cardiology and Angiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
⁵ Cardiology Unit, Department of Medicine, Karolinska University Hospital, Solna, 171 76 Stockholm, Sweden.
⁶ Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, Ospedale Cisanello, 56124 Pisa, Italy.
⁷ Division of Vascular Medicine, Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
⁸ Department of Cardiology, Charité - Universitätsmedizin Berlin (CBF), 12203 Berlin, Germany.
⁹ Service de Pharmacologie and INSERM U 970, Université Paris-Descartes, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 75015 Paris, France.
¹⁰ 2(nd) Department of Cardiology, Athens University Medical School, Attikon University Hospital, Athens, Greece.
¹¹ Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London NW3 2QG, United Kingdom.
¹² 2(nd) Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
¹³ Hypertension Unit & Cardiovascular Research Laboratory, 1st Department of Internal & Propedeutic Medicine, Laiko General Hospital, National & Kapodistrian University of Athens, Greece.
¹⁴ Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
¹⁵ Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, 4052 Basel, Switzerland.
¹⁶ Heymans Institute of Pharmacology, Ghent University, 9000 Ghent, Belgium.
¹⁷ Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria.
¹⁸ Department of Cardiology, Tokyo Medical University, 160-0023 Tokyo, Japan.
¹⁹ Department of Medicine and Hypertension Institute, Brunner Institute for Cardiovascular Research, Sackler Faculty of Medicine, Tel-Aviv University, The E. Wolfson Medical Center, Holon 58100, Israel.
²⁰ Department of Pharmacology and INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Paris 75015, France.
²¹ Department of Cardiology, Wales Heart Research Institute, Cardiff CF14 4XN, United Kingdom.
²² St Vincent's Clinic, University of New South Wales, Victor Chang Cardiac Research Institute, Sydney, Australia.
²³ Department of Medicine/Cardiology, Cheil General Hospital, Dankook University College of Medicine, Seoul 100-380, Republic of Korea.
²⁴ Unit of Internal Medicine, Department of Medicine, University of Perugia and Terni University Hospital, Terni, Italy.
²⁵ Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark.
²⁶ Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, Philadelphia, United States.

PMID: 26117398
DOI: 10.1016/j.atherosclerosis.2015.05.007

Free article

Review

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society

Charalambos Vlachopoulos et al. Atherosclerosis. 2015 Aug.

Free article

. 2015 Aug;241(2):507-32.

doi: 10.1016/j.atherosclerosis.2015.05.007. Epub 2015 May 16.

Authors

Affiliations

¹ Peripheral Vessels Unit, 1st Department of Cardiology, Athens University Medical School, Hippokration Hospital, Athens, Greece.
² Department of Cardiology, Dupuytren University Hospital, Limoges, France.
³ Department of Angiology, University Hospital Graz, 8036 Graz, Austria.
⁴ Department of Cardiology and Angiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
⁵ Cardiology Unit, Department of Medicine, Karolinska University Hospital, Solna, 171 76 Stockholm, Sweden.
⁶ Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, Ospedale Cisanello, 56124 Pisa, Italy.
⁷ Division of Vascular Medicine, Ospedale San Giovanni, 6500 Bellinzona, Switzerland.
⁸ Department of Cardiology, Charité - Universitätsmedizin Berlin (CBF), 12203 Berlin, Germany.
⁹ Service de Pharmacologie and INSERM U 970, Université Paris-Descartes, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 75015 Paris, France.
¹⁰ 2(nd) Department of Cardiology, Athens University Medical School, Attikon University Hospital, Athens, Greece.
¹¹ Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London NW3 2QG, United Kingdom.
¹² 2(nd) Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
¹³ Hypertension Unit & Cardiovascular Research Laboratory, 1st Department of Internal & Propedeutic Medicine, Laiko General Hospital, National & Kapodistrian University of Athens, Greece.
¹⁴ Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
¹⁵ Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, 4052 Basel, Switzerland.
¹⁶ Heymans Institute of Pharmacology, Ghent University, 9000 Ghent, Belgium.
¹⁷ Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria.
¹⁸ Department of Cardiology, Tokyo Medical University, 160-0023 Tokyo, Japan.
¹⁹ Department of Medicine and Hypertension Institute, Brunner Institute for Cardiovascular Research, Sackler Faculty of Medicine, Tel-Aviv University, The E. Wolfson Medical Center, Holon 58100, Israel.
²⁰ Department of Pharmacology and INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Paris 75015, France.
²¹ Department of Cardiology, Wales Heart Research Institute, Cardiff CF14 4XN, United Kingdom.
²² St Vincent's Clinic, University of New South Wales, Victor Chang Cardiac Research Institute, Sydney, Australia.
²³ Department of Medicine/Cardiology, Cheil General Hospital, Dankook University College of Medicine, Seoul 100-380, Republic of Korea.
²⁴ Unit of Internal Medicine, Department of Medicine, University of Perugia and Terni University Hospital, Terni, Italy.
²⁵ Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark.
²⁶ Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, Philadelphia, United States.

PMID: 26117398
DOI: 10.1016/j.atherosclerosis.2015.05.007

Abstract

While risk scores are invaluable tools for adapted preventive strategies, a significant gap exists between predicted and actual event rates. Additional tools to further stratify the risk of patients at an individual level are biomarkers. A surrogate endpoint is a biomarker that is intended as a substitute for a clinical endpoint. In order to be considered as a surrogate endpoint of cardiovascular events, a biomarker should satisfy several criteria, such as proof of concept, prospective validation, incremental value, clinical utility, clinical outcomes, cost-effectiveness, ease of use, methodological consensus, and reference values. We scrutinized the role of peripheral (i.e. not related to coronary circulation) noninvasive vascular biomarkers for primary and secondary cardiovascular disease prevention. Most of the biomarkers examined fit within the concept of early vascular aging. Biomarkers that fulfill most of the criteria and, therefore, are close to being considered a clinical surrogate endpoint are carotid ultrasonography, ankle-brachial index and carotid-femoral pulse wave velocity; biomarkers that fulfill some, but not all of the criteria are brachial ankle pulse wave velocity, central haemodynamics/wave reflections and C-reactive protein; biomarkers that do no not at present fulfill essential criteria are flow-mediated dilation, endothelial peripheral arterial tonometry, oxidized LDL and dysfunctional HDL. Nevertheless, it is still unclear whether a specific vascular biomarker is overly superior. A prospective study in which all vascular biomarkers are measured is still lacking. In selected cases, the combined assessment of more than one biomarker may be required.

Keywords: Ankle-brachial index; Arterial stiffness; Carotid ultrasonography; Central haemodynamics; Circulating biomarkers; Endothelial function; Vascular biomarkers; Wave reflections.

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The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society

Affiliations

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society

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Abstract

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