Biomarkers for atherosclerosis: pathophysiological role and pharmacological modulation

In an attempt to improve global cardiovascular risk prediction, considerable effort has been made in the discovery and characterization of soluble biomarkers which can go beyond the measure of total and LDL cholesterol levels. In particular, circulating molecules related to chronic inflammation have emerged as potential biomarkers for atherosclerosis. Evidence, obtained from in-vitro and in-vivo experimental models, has also documented that the majority of biomarkers play a pathological role in atherogenesis. Epidemiological and clinical studies have shown strong and consistent relationships between markers of inflammation and risk for cardiovascular disease events. Biomarkers not only provide new important diagnostic and prognostic information, but may be useful to determine the pathological role of inflammatory circulating molecules in the development of atherosclerotic lesions. Moreover, biological markers may serve to identify new patients at risk of cardiovascular disease, to monitor the efficacy of antiatherosclerotic treatments, and to develop new pharmacological tools for the treatment of atherosclerosis. Multiple screening of different biomarkers may therefore improve the assessment of risk, diagnosis, and prognosis for cardiovascular disease. In addition, soluble biomarkers have been shown to be modulated by hypolipidemic drugs and to be potentially useful in determining the clinical benefits of pharmacological therapies that do not alter serum lipid levels.