A critical appraisal of the use of inflammatory biomarkers in risk prediction of atherosclerosis

Abstract

Background: Atherosclerosis is a systemic disease that is the underlying cause of many cardiovascular diseases. Atherosclerosis begins with a fatty streak which may progress to an advanced lesion which may lead to plaque rapture and consequently bleeding and thrombosis. Recently, it has been appreciated that atherosclerosis is predominantly an inflammatory process. Inflammation plays an essential role in all atherosclerosis stages. Cardiovascular disease risk prediction remains one challenging area. A number of biomarkers has been investigated as potential tools for the enhancement of cardiovascular risk prediction. In this study, the inflammatory markers such as C-reactive protein and interleukin-6 have been investigated as biomarkers for atherosclerosis in allowing for stratification of patients who would benefit from interventional treatment. Aims: To carry out an extended literature review to identify different inflammatory biomarkers of atherosclerosis and critically analyse the ability of using these markers in cardiovascular diseases risk prediction. Methods: A literature search using various key terms including C-reactive protein, interleukin-6, cardiovascular disease and atherosclerosis Results: According to research elevated CRP and IL-6 concentrations among health men and women are associated with incidence of future cardiovascular disease events. Thus, these markers could be a good candidate for the enhancement cardiovascular disease risk prediction. However, until now there is no evidence about the predictive value of these biomarkers and therefore, they cannot be recommended for routine clinical use. In a low risk population man ≥ 50 years of age and women ≥ 60 years of age with LDL < 3.4 mmol/L, hsCRP concentration could be useful in the selection of patients for statin therapy. There are currently no recommendations about using IL-6 measurements in guidance of patient treatment. Conclusion: Although according to discussed findings inflammatory markers were shown to be associated with the risk of future cardiovascular events in healthy individuals, their clinical utility is still not fully clear. Further studies should focus on the reliability and accuracy of these biomarkers.