Biobanks and the search for predictive biomarkers of local and systemic outcome in atherosclerotic disease

Rob Hurks; Wouter Peeters; Wouter J. M. Derksen; Willem E. Hellings; Imo E. Hoefer; Frans L. Moll; Dominique P. V. de Kleijn; Gerard Pasterkamp

doi:10.1160/TH08-07-0488

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2009; 101(01): 48-54
DOI: 10.1160/TH08-07-0488

Review Article

Schattauer GmbH

Biobanks and the search for predictive biomarkers of local and systemic outcome in atherosclerotic disease

Rob Hurks

¹Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

²Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

,

Wouter Peeters

¹Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

³Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands

,

Wouter J. M. Derksen

¹Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

,

Willem E. Hellings

¹Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

²Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

,

Imo E. Hoefer

¹Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

,

Frans L. Moll

²Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

,

Dominique P. V. de Kleijn

¹Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

³Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands

,

Gerard Pasterkamp

¹Experimental Cardiology Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands

› Author Affiliations

Abstract

Summary

Multiple risk factors have been associated with progression of atherosclerosis. To identify the individual patient who is at risk for disruption of a vulnerable plaque, leading to a cardiovascular event, remains a major challenge. Current screening methods, based on traditional risk factors, do not allow risk stratification on an individual level. The discovery of new biomarkers would aid in identifying specific patient groups at risk for adverse cardiovascular events due to atherosclerotic disease progression. The current definition of the vulnerable plaque, e.g. atheromatous inflammatory plaque with a thin fibrous cap, has been based on cross-sectional post-mortem studies. The predictive value of these histological characteristics of the vulnerable plaque is likely to be low, because they are also frequently observed at multiple locations in symptomatic and asymptomatic patients. The Athero-express study follows a new concept to search for the atherosclerotic patient who may suffer from adverse events. In this study, we investigate the predictive value of local plaque composition for adverse events in other vascular territories, regarding the plaque as a concentrated expression of this systemic disease. First results from this longitudinal biobank study show that the local plaque hides strong predictive value for cardiovascular events elsewhere in the vascular tree. Longitudinal biobank studies will facilitate the identification of novel local plaque markers. The search for the plaque protein signature that is predictive for adverse events might enable patient stratification that will allow individualized tailor made medicine and subsequently guide the choice for therapeutic interventions.

Keywords

Atherosclerosis - biobank - vulnerable plaque - biomarker - plaque signature

Full Text

References

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