To briefly summarize recently published evidence in the field of cardiovascular proteomics, focusing on its ability to improve cardiovascular risk stratification and critically discussing still open and burning issues and future perspectives of proteomics research.
Several epidemiological studies have demonstrated an improvement in cardiovascular risk prediction beyond traditional risk factors by adding novel biomarkers, identified by both discovery and targeted proteomics. However, only a moderate improvement in risk discrimination over clinical variables was observed. Moreover, despite different outcomes there was also a strong overlap of identified candidates, with several of them being already well established cardiovascular risk markers such as growth differentiation factor 15, natriuretic peptides, C-reactive protein, interleukins, and metalloproteases.
Although proteomics plays a crucial role in biomarker discovery, the modest discriminative ability of this technique raises the possibility that there are still hidden mechanisms in protein regulatory networks, which urgently need to be evaluated to improve a cardiovascular risk assessment to a clinically significant extent.
aPreventive Cardiology and Preventive Medicine, Centre for Cardiology, University Medical Centre of the Johannes Gutenberg-University Mainz
bDZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz
cDeutsches Herzzentrum München, Technische Universität München, München
dDZHK (German Centre for Cardiovascular Research), partner site Munich Heart, Alliance, Germany
eInstitute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
Correspondence to Wolfgang Koenig, MD, PhD, FRCP, FACC, FAHA, FESC, Deutsches Herzzentrum München, Technische Universität München, Lazarettstr. 36, 80636 München, Germany. Tel: +49 89 1218 4073; fax: +49 89 1218 2023; e-mail: email@example.com
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