Review Article

Clinical Usefulness of Novel Serum and Imaging Biomarkers in Risk Stratification of Patients with Stable Angina

Table 1

Summary of the most important data in this review, regarding biomarker use for risk stratification of SA patients.

BiomarkerStudyComments

hs-CRPCushman et al., 2005 [8]Elevated CRP levels were independently associated with increased 10-year risk of CHD in intermediate-Framingham-risk men and high-Framingham-risk women.

GDF-15Kempf et al., 2009 [13]GDF-15 remained an independent predictor of CHD mortality in SA patients (P < 0.001). Addition of GDF-15 improved the prognostic accuracy of a clinical risk prediction model concerning CHD mortality.

NeopterinEstévez-Loureiro et al., 2009 [18]Neopterin was found to be independent predictor of LV dysfunction in SA patients (P = 0.040).

IL-6Tanindi et al., 2011 [22]IL-6 levels were correlated with severe LAD stenosis (P < 0.001) and higher angiographic Gensini score (P < 0.001) in SA patients.

IL-10Cavusoglu et al., 2011 [131]Baseline elevated IL-10 levels were an independent predictor of adverse outcome in ACS patients.

IL-17Liang et al., 2009 [43]Significant correlation was found between plasma MPO and IL-17 levels in all study participants ( , P < 0.05).

MPOLiang et al., 2009 [43]No significant difference between the control (24.2 ± 5.7  g/L) and SA groups (26.3 ± 4.8  g/L). MPO levels in patients with ACS (93.6 ± 20.3 µg/L) were significantly higher than in patients with SA and the healthy control subjects (P < 0.05).

SDF-1; CXCL-12Stellos et al., 2011 [58]No correlation of SDF-1 with any biochemical parameter (except an inverse correlation with cholesterol levels, P = 0.035), either in the whole study population or in the SA group. No statistical difference in SDF-1 levels between NSTEMI and SA groups.

PCT Sinning et al., 2011 [67] Increased PCT levels in ACS group than in SA group (P for trend was P < 0.0001). Increased PCT levels at baseline were related to higher cardiovascular mortality (P = 0.00018) and higher cardiovascular event rate (P = 0.026). Also, independently related to future cardiovascular death (HR: 1.34; 95% CI: 1.08–1.65; P = 0.0070) when adjusted for clinical variables.

Fetuin-ABilgir et al., 2010 [70]Decreased fetuin-A levels in SA group than in controls. Higher fetuin-A levels in SA patients, compared to AMI patients (1.67 ± 0.20 ng/mL versus 1.56 ± 0.21 ng/mL, P = 0.020).

Lp-PLA2Ikonomidis et al., 2011 [79]Major risk factor for CHD and also fatal cardiovascular events, mainly in lipidemic middle-aged men.

MMP-8, MMP-9Jönsson et al., 2011 [89]Both MMP-8 and MMP-9 levels did not correlate with clinical characteristics. No difference in serum or plasma levels of MMP-8/MMP-9 between SA patients and controls.

TIMP-1, TIMP-2Brunner et al., 2010 [91], Fiotti et al., 2008 [94], Jönsson et al., 2011 [89]No significant difference in TIMP-1/TIMP-2 levels between SA groups and controls.

CopeptinVon Haehling et al., 2012 [107]Higher baseline copeptin levels in patients with family CAD history. Patients with serum level ≥20.4 pmol/L suffered more events of the combined primary endpoint and of all-cause death in 90 days.

ACS: acute coronary syndrome; CHD: chronic heart disease; CAD: coronary artery disease; SA: stable angina; AMI: acute myocardial infarction; STEMI: ST-elevation myocardial infarction; NSTEMI: non-ST elevation myocardial infarction; LV: left ventricle; LAD: left anterior descending artery; CRP: C-reactive protein; GDF-1: growth differentiation factor-1; IL-6: interleukin-6; IL-10: interleukin-10; IL-17: interleukin-17; MPO: myeloperoxidase; SDF-1: stromal-cell derived factor-1; CXCL-12: C-X-C motif ligand 12; PCT: procalcitonin; MMP: matrix metalloproteinase; TIMP: tissue inhibitor of metalloproteinases.