What Markers Predict Cardiovascular Disease?

What are the biochemical patterns that determine whether one person will fall prey to cardiovascular disease and another will escape unscathed?

Those are the kinds of questions being addressed at the Baylor College of Medicine/The Methodist Hospital Center for Cardiovascular Disease Prevention under the direction of Christie Ballantyne, M.D., professor of medicine.

“We are on the threshold of having completely novel therapies to treat vascular disease,” said Ballantyne, director of the two-year-old center. “We are looking at new drugs now that will work directly at the vessel wall,” where many of the problems in cardiovascular disease begin.

Researchers in the center’s atherosclerosis laboratory focus on verifying old markers for cardiovascular disease, while setting their sites on new markers that may be able to predict patients’ susceptibility to negative outcomes.

“Much of the new work focuses on inflammation and markers that could give us the upper hand in predicting diabetes, heart attack and stroke,” he said. “I’m looking at a panel of inflammatory markers including high sensitivity C-reactive protein, orosomucoid (a protein whose levels increase during inflammation or tissue damage), and sialic acid (another chemical associated with inflammation).”

Any one marker might not tell researchers much, he said, but by using a panel of markers simultaneously they can get a clearer message from a blood sample.

New technology allows Ballantyne and the research team to look at large numbers of markers at the same time. “It’s a little like looking at gene arrays, where they scan 50,000 genes,” he said. “Out of the 50,000, they may find 10 to 25 that seem promising. The new technology we are using allows us to look at that smaller group in greater detail.”

A challenge facing Ballantyne is determining how well new therapies are affecting patients in the short term. Once markers are used to improve risk assessment – or identify those most susceptible to heart attack or stroke – how could blood markers be used to determine how well a therapy is working?

“This is a totally new era in atherosclerosis,” he said. “In the near future, we could use these blood markers to not only determine risk, but also the response to therapy. What we need to know is if we are being aggressive enough in treating the problem, or if we could possibly prescribe additional therapies.”

Another area of research in which Ballantyne is interested is the metabolic syndrome. He, along with researchers from the University of North Carolina and the Merck Research Laboratory in West Point, Pa., are studying the syndrome’s link to coronary heart disease and stroke, and a paper on their work was recently presented at the American Heart Association’s 75th annual Scientific Sessions in Chicago.

Symptoms of metabolic syndrome, as defined by the National Cholesterol Education Program, include any of the following: elevated blood pressure, high fasting glucose, high triglycerides, low HDL and a large waist circumference.

After following the medical history of more than 12,000 men and women, aged 45 to 64, for 11 years, Ballantyne and his research team found that people who have metabolic syndrome have a significantly higher incidence of both coronary heart disease and stroke.

“We need further research to determine which individuals with the syndrome are at greatest risk and which therapies are most appropriate,” said Ballantyne.

Since its inception, the center has set the bar high – aiming to become the number one center of translational research in the prevention and treatment cardiovascular disease.

It has already established a leading national role in education. Ballantyne serves as editorial director of www.lipidsonline.org. The web site, designed for medical educators, is one of the most frequently used sites in the area of lipids and atherosclerosis.

– Reprinted from Baylor College of Medicine’s “From the Laboratories” online newsletter, available at http://www.fromthelab.net.

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©2006 Texas Medical Center

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