Proteins and Peptides as Biomarkers for Diagnosis of Cardiovascular Diseases

With the increase in the prevalence of cardiovascular diseases internationally, particularly cardiac failure (CF) and atherosclerosis, the investigation for new biological markers remains one of the main priorities. In contrast to complicated diagnostic methods that might not be appropriate to be employed on a larger population, biological markers are effective for the screening of the population. Owing to their non-invasive detection with typically high accuracy and sensitivity, circulating biomarkers have become increasingly significant for routine medical practice. Cardiac troponins and natriuretic peptides (NPs), specifically brain NP (BNP), mid-regional pro arterial NP, and N-terminal (NT) pro BNP, are validated blood biological markers in the diagnosis of CF and prediction of CF-associated outcomes. Inflammatory proteins like C-reactive protein can also have increased importance in anti-inflammatory treatment guidance. Moreover, next-generation biological markers like galectin-3, growth/differentiation factor 15, diverse miRNAs, and soluble suppression of tumorigenicity-2 might have additional value in the analysis of ventricular remodeling and differentiation of CF subtypes. In this chapter, we will first discuss the biological markers as per the major categories of cardiovascular disease, i.e., myocardial stress, inflammation, plaque instability, myocardial injury, systemic stress, calcium homeostasis, and platelet activation. Lastly, we will describe the multimarker methods, including various combinations of novel and established biomarkers that may improve the risk prediction of CF at the population level.

Keywords: Acute cardiac infractions, Cardiovascular diseases (CVD), Cardiac failure (CF), Congenital heart diseases (CHD), Natriuretic peptides (NPs).