Molecular Markers for Atherosclerosis

Abstract

Although cardiovascular disease remains the leading cause of morbidity and mortality in both men and women of all racial groups in the United States, recent clinical trials clearly show that treatment of risk factors such as hyperlipidemia reduces both morbidity and mortality from cardiovascular disease [1]. One of the key necessities for implementation of preventive strategies is to identify high-risk individuals. The cost-effectiveness of therapy varies greatly depending on the risk status of the individual considered for therapy. Treatment of low-risk individuals may not be affordable by government or private health-care plans. For these reasons, the intensity of lipid-lowering therapy is dependent on the risk status of the patient in the treatment guidelines used in both the United States and in Europe. Patients who have clinical evidence of coronary heart disease (CHD) or other vascular disease are at increased risk, and patients who have more extensive atherosclerosis as documented by coronary angiography or ultrafast computed tomography (CT) of the heart have increased risk for coronary events. Waiting until patients develop either symptoms or clinical findings of vascular disease is not feasible because, unfortunately, for many patients the first presenting symptom is sudden cardiac death. Early detection programs such as ultrafast CT scans and positron-emission tomography (PET) are expensive and cannot be easily offered in all practice settings.