| Abstract
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Introduction
Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality
in the United States. Primary prevention and secondary prevention of CVD
are public health priorities. Substantial data indicate that CVD is a
life course disease that begins with the evolution of risk factors that
in turn contribute to the development of subclinical atherosclerosis.
Subclinical disease culminates in overt CVD. The onset of CVD itself portends
an adverse prognosis with greater risk of recurrent events, morbidity,
and mortality. It is also increasingly clear that although clinical assessment
is the keystone of patient management, such evaluation has its limitations.
Clinicians have used additional tools to aid clinical assessment and to
enhance their ability to identify the "vulnerable" patient at
risk for CVD, as suggested by a recent National Institutes of Health (NIH)
panel. Biomarkers are one such tool to better identify high-risk individuals,
to diagnose disease conditions promptly and accurately, and to effectively
prognosticate and treat patients with disease. This review provides an
overview of the molecular basis of biomarker discovery and selection and
the practical considerations that are a prerequisite to their clinical
use.
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