Abstract

Many recent experimental and clinical studies have provided evidence forthe presence of inflammation in atherosclerotic lesions. Ongoing inflammatory reactions within coronaryatherosclerotic plaques are increasingly thought to be crucial determinants of the clinical course ofpatients with coronary artery disease (CAD). These facts lead to a search for reliable markers reflectingthe inflammatory process in the atherosclerotic plaques. Circulating markers may consist of cytokinesdirectly released from inflammatory cells present in the plaques and tissues exposed to recurrent ischemiaas well as other reactants produced in response to these cytokines such as adhesion molecules and acutephase proteins. Recent studies suggest that markers of inflammation may reflect different aspects ofthe atherothrombotic process at different points in the continuum of acute coronary syndromes, have apotential role for the prediction of risk for developing CAD, and may correlate with severity and futurerisk for CAD. In spite of these findings, the clinical utility of measuring these markers is limitedby the availability of reproducible diagnostic test assays. In addition, it remains to be determinedwhether markers of inflammation actually have a causal relation with cardiovascular disease, or simplyreflect the underlying disease process. Such determination becomes important with the potential use ofthese markers in targeting preventive therapies. Therefore, further well-designed prospective evaluationof each of these markers is needed before their use in routine practice.

Keywords: Acute-Phase Proteins, Apolipoproteins, Biological Markers, C-Reactive Protein, Cell Adhesion Molecules, Coronary Arteriosclerosis, Cytokines, Fibrinogen, Interleukin-1, Interleukin-6, Serum Amyloid A Protein