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Biochemical and bioimaging markers for risk assessment and diagnosis in major cardiovascular diseases: a road to integration of complementary diagnostic tools

  1. S. M. Marcovina1,
  2. F. Crea2,
  3. J. Davignon3,
  4. J. C. Kaski4,
  5. W. Koenig5,
  6. U. Landmesser6,
  7. P. L. Pieri7,
  8. J. Schulz-Menger8,
  9. L. J. Shaw9,
  10. J. Sobesky10

Article first published online: 18 JAN 2007

DOI: 10.1111/j.1365-2796.2006.01734.x

Issue

Journal of Internal Medicine

Journal of Internal Medicine

Volume 261, Issue 3, pages 214–234, March 2007

Additional Information

How to Cite

Marcovina, S. M., Crea, F., Davignon, J., Kaski, J. C., Koenig, W., Landmesser, U., Pieri, P. L., Schulz-Menger, J., Shaw, L. J. and Sobesky, J. (2007), Biochemical and bioimaging markers for risk assessment and diagnosis in major cardiovascular diseases: a road to integration of complementary diagnostic tools. Journal of Internal Medicine, 261: 214–234. doi: 10.1111/j.1365-2796.2006.01734.x

Author Information

  1. 1

    From the Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA, USA

  2. 2

    Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy

  3. 3

    Hyperlipidemia and Atherosclerosis Research Group, Clinical Research Institute of Montreal, Montreal, Canada

  4. 4

    Department of Cardiological Sciences, St George's Hospital Medical School, London, UK

  5. 5

    Medizinische Univerisitaetsklinik, Ulm

  6. 6

    Medizinische Hochschule Hannover, Hannover, Germany

  7. 7

    U.O. Medicina Cardiovascolare, Ospedale M. Bufalini, Cesena, Italy

  8. 8

    Franz-Volhard-Klinik, Charité Campus Buch, Helios-Clinics, University Medicine Berlin, Berlin, Germany

  9. 9

    Cedars – Sinai Medical Center, Division of Cardiology, Los Angeles, CA, USA

  10. 10

    Department of Neurology, University of Cologne, Cologne, Germany

*Santica Marcovina, PhD, ScD, Research Professor of Medicine, Northwest Lipid Metabolism & Diabetes Research, Laboratories, University of Washington, 401 Queen Anne Avenue North, Seattle, WA 98109, USA. (fax: 206 685 3279; e-mail: smm@u.washington.edu).

Publication History

  1. Issue published online: 18 JAN 2007
  2. Article first published online: 18 JAN 2007

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Keywords:

  • acute coronary syndrome;
  • biochemical markers;
  • bioimaging cardiovascular disease;
  • congestive heart failure;
  • stroke

Abstract.

This report from the first International Course on Integrated Biomarkers, Biochemical and Bioimaging Endpoints in Cardiovascular Diagnosis, Prevention, Therapy and Drug Development provides the basis for optimizing diagnostic, prognostic and therapeutic information in four areas of cardiovascular medicine: primary prevention of cardiovascular diseases, acute coronary syndromes, heart failure and stroke. Risk stratification and treatment strategies can be refined and enhanced through integration of bioimaging and biochemical markers to characterize sub-clinical and clinical atherosclerosis. For the integrative approach to be useful, each of the biomarkers must be validated and cost-effective. Clinical decision is the primary level of integration and is based on clinical evaluation and the use of a combination of bioimaging and biochemical markers. The decision to initiate preventive or therapeutic intervention must take into account the factors affecting the levels of expression of the biomarker and the potential input the biomarker has on metabolic processes or modulation of other biomarkers. The optimal approach to intervention must take into consideration the risk–benefit and cost–effectiveness ratios.

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