Published online Feb 20, 2015. doi: 10.5493/wjem.v5.i1.21
Peer-review started: August 14, 2014
First decision: September 28, 2014
Revised: October 30, 2014
Accepted: November 19, 2014
Article in press: November 19, 2014
Published online: February 20, 2015
Coronary artery disease is an event of atherosclerosis characterized by a chronic vascular inflammation. Risk factors like obesity, diabetes mellitus, hypertension, smoking, hypercholesterolemia and positive family history sometimes are not sufficiently adequate to the enhancement of cardiovascular risk assessment. In the past years numerous biomarkers, like C reactive protein, cytokines and adhesion molecules, have been observed to be related to adverse cardiovascular prognosis. Recently, several studies found an association among inflammatory biomarkers and cardiovascular diseases suggesting their utility to identify the risk of an acute ischemic event and the detection of vulnerable plaques. The emerging inflammatory markers are well divided for diagnosis and prognosis and plaque instability of coronary artery disease. Some of them, the lectin-like oxidized low density lipoprotein receptor-1 can be important both in diagnosis and in the evaluation of plaque instability, other are inserted in the above reported classification. The emerging inflammatory markers in acute-phase include amyloid A, fibrinogen and pentraxin 3 while myeloperoxidase, myeloid-related protein 8/14 and pregnancy-associated plasma protein-A are recognize markers of plaque instability. Lastly, some studies demonstrated that circulating miRNAs are involved in coronary artery disease, acute myocardial infarction and heart failure.
Core tip: In this review we want to focus the reader’s attention on the differences between inflammatory markers of cardiovascular risk already accepted by the scientific community and the emerging markers in order to encourage the healthcare services to improve laboratory techniques in early diagnosis and more precise evaluation of the risk. Is also important to use a classification according to the stage where the patient is located regarding emerging inflammatory markers for diagnosis, prognosis and plaque instability.