Cardiac & Metabolic Diagnostics
Cardiovascular and metabolic diseases are the leading cause of death globally. An aggressive approach to their diagnosis and treatment can substantially reduce the risk of mortality and life-
threatening complications. Cardiovascular disease (CVD) is a major health problem across the world, accounting for a third of all deaths worldwide. It is often grouped with metabolic disorders because it is frequently a consequence of diabetes and dyslipidemia. However the group of disorders specifically related to CVD include coronary heart disease, cerebrovascular disease, and peripheral arterial disease. Cardiac biomarker assays have proven to be particularly useful in providing a rapid diagnosis and assessing risk in people with acute coronary syndrome (ACS). Cardiac markers are proteins, hormones, enzymes or other substances expressed by myocardial cells and they are released into the circulating blood upon cell necrosis. Several biomarkers that have become routinely used in the clinic include creatine kinase (CK), creatine kinase-MB
Retrieved 2013: www.cardiac-biomarkers.com
(CK-MB), myoglobin, cardiac troponin T (cTnT), and cardiac troponin I (cTnI). To date, the troponins have proven to be the most sensitive and specific indicators of cardiac injury. Other useful biomarkers include NT-proBNP which can help predict an increased risk of recurrent events after a heart arythmia. New potential cardiac biomarkers are continually being researched, and advances in functional genomics, proteomics, metabolomics, and bioinformatics have revolutionized the discovery process. In general, using more than one biomarker increases the early predictive value compared to using on a single marker and technological advances will increase the use of multi-marker profiling to improve and possibly individualize treatment of CVD in the future. Metabolic diseases include disorders that disrupt normal metabolism such as diabetes and dyslipidemia (abnormal lipid metabolism). These diseases can be brought on by primary (genetic) factors or secondary factors related to lifestyle, environment, or medication. Metabolic syndrome is a specific collection of conditions that can increase the risk of diabetes, stroke and heart disease and it affects 25% of the adult world population. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria to be used in clinical practice to identify patients with metabolic syndrome. These risk factors include elevated waist circumference, elevated
triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting glucose. The magnitude of the increased risk can vary according to which components of the syndrome are present plus the other, non-metabolic syndrome risk factors in a particular person.
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Cardiac & Metabolic Markers for Assay Development
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