Biomarkers for Cardiovascular Disease

Cardiovascular events are a major cause of morbidity and mortality world-wide and traditional risk factor assessment is limited in its ability to predict which patients will have an event. The endothelium is known to play a central role in vascular homeostasis and nitric oxide (NO) is believed to be the main component responsible for normal endothelial function. Increasing evidence suggests that oxidative stress leading to reduced NO bioavailability and subsequent endothelial dysfunction is an important factor in the progression of vascular diseases. Further investigation of NO metabolites in blood may provide insight into the mechanisms of endothelial dysfunction and disease progression. Preliminary data suggest that although plasma nitrite levels are decreased in CAD patients and correlate with endothelial dysfunction, the nitrite within red blood cells and whole blood is compensatorily increased. Since this new measure is more reproducible and convenient to measure, it may serve as a biomarker of endothelial dysfunction. A prospective study of nitrite and other novel NO-based assays, proteomics, and current biomarkers linked to endothelial function phenotype will allow further investigation into the pathophysiology of endothelial dysfunction and permit development of future markers of atherothrombosis.