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Biomarkers of Inflammation as Surrogate Markers in Detection of Vulnerable Plaques and Vulnerable Patients

M. Madjid,S. Casscells,J. Willerson

Published 2007 in Unknown venue

ABSTRACT

C-reactive protein (CRP) activates endothelial cells to express adhesion molecules, VCAM and ICAM, and Monocyte Chemotactic Protein, and CRP decreases the availability of nitric oxide. Thus, it is a proinflammatory substance and its serum level is also a predictor of future vascular events. White blood cell counts are independent predictors of cardiovascular events. Lipoprotein-associated phospholipase A2 (Lp-PLA2) may have both proinflammatory and antiinflammatory effects. High Lp-PLA2 levels predict future cardiovascular events. Myeloperoxidase is proinflammatory and its serum level is a predictor of prognosis of cardiovascular events in patients. In troponin-negative acute coronary syndrome (ACS) patients, elevated pregnancy-associated plasma protein-A is an independent predictor of adverse outcome during 6 months of follow-up. Elevated serum amyloid A at hospital admission in patients with unstable angina predicts a poorer prognosis. CD40 and CD40 ligand levels predict prognosis in patients with ACS. The primary proinflammatory cytokines are interleukin-1 and -6 and tumor necrosis factor-α. Increased serum levels of the proinflammatory cytokines are associated with a poorer prognosis, development of congestive heart failure (CHF), and of progressive atherosclerosis. Increased serum levels of interleukin-10 are associated with a better prognosis in patients with coronary artery disease (CAD).

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