ABSTRACT
Atherosclerosis is a chronic, progressive, infl ammatory, and very complex disease of large and medium-sized muscular arteries with a long asymptomatic phase. Evidence indicates that atherosclerosis begins in childhood with the accumulation of lipid in the intima of arteries to form fatty streaks (McGill 1988). Nearly all children have at least some degree of aortic fatty streaks by 3 years of age (Napoli et al. 2005), and these fatty streaks increase after 8 years of age (Strong et al. 1962), with atherosclerotic plaques present in the coronary arteries during adolescence (Stary et al. 1992). This atherosclerotic process results in changes in the structure and function of the arterial tree (Ross 1999). Disease progression can lead eventually to the occurrence of acute cardiovascular events such as myocardial infarction, unstable angina pectoris and sudden cardiac death. Cardiovascular disease is the leading cause of death in Western societies. Statistics show CAD to be the leading cause of death among both men and women in the United States and in Europe. For example, approximately 12,800,000 Americans suffer from CAD and nearly 500,000 Americans die from heart attacks caused by CAD. Over 12 million Americans have a history of myocardial infarction or angina or both (Roger et al. 2011). Similarly, two million Europeans die from CAD each year. Death rates from CAD are higher in Northern, Central and Eastern Europe and lower in Southern and Western Europe (European cardiovascular disease statistics 2008). Based on the aforementioned data,
1st Department of Cardiology, ‘Hippokration’ Hospital, University of Athens Medical School, Athens, Greece. *Corresponding author: drtousoulis@hotmail.com
it is obvious that the diagnosis of atherosclerosis in the early stages of the disease can be the cornerstone in the prevention of future cardiovascular disease. In order to be able to achieve this goal, the establishment of precise and reliable biomarker tests for the early stages of atherosclerosis is of great importance. The ideal biomarker should have the following characteristics: highly sensitive, specifi c, reliable, accessible, standardized, dependable, cost effective, and easily interpretable by clinicians. In this chapter, we will focus on the presentation and evaluation of the most promising biochemical markers used in risk assessment of premature atherosclerosis.
