A Look at Emerging Cardiac Biomarkers

Serum-based biomarkers have been integral to the advancement of the field of cardiology during the past half-century, and with better knowledge about their role in the pathophysiology of cardiovascular disease (CVD), their utility has expanded from merely aiding in the diagnosis of disease to being important in predicting risk and prognosis. Some, such as the natriuretic peptides, B-type natriuretic peptide (BNP) and its amino-terminal pro peptide equivalent, N-terminal-proBNP (NT-proBNP), also are being actively explored as a means of guiding therapy. Novel biomarkers continue to be evaluated, along with new lines of investigation, including genomics and metabolomics, which hold the potential for even greater insights into CVD and its treatments.

      Though by any measure this progress has been significant, the best may be yet to come, according to Fred Apple, PhD, medical director of clinical laboratories at Hennepin County Medical Center and professor of laboratory medicine and pathology at the University of Minnesota School of Medicine, in Minneapolis. “Our world is expanding in the sense that predominantly we’ve been using proteins to follow diagnosis and are now slowly inching into following outcomes. In the protein world, the question is, are there going to be other biomarkers that complement or replace the current ones that are pretty solid,” he said. “Now, looking down the road, there’s clearly growth in genomics and metabolomics, and the questions will be, how will these emerging fields assist in detecting disease early on, and how will they improve patient outcomes and care?” Apple co-edited the January issue of Clinical Chemistry, which explores the impact of biomarkers, proteomics, and genomics in CVD.