American Association for Clinical Chemistry
Better health through laboratory medicine
Heads Up: March 27, 2008

The Strategies Editorial Advisory Board recommends the following recent papers:

Diagnostic Markers for Early Detection of Ovarian Cancer
Six diagnostic markers for early ovarian cancer provide a significant improvement over CA-125 by itself for detecting ovarian cancer, according to a multicenter trial. A paper published in Clinical Cancer Research describes the first blood biomarker test with a sensitivity of 95.3% and a specificity of 99.4%. This novel multiplex platform has the potential for efficient screening of patients at high risk for ovarian cancer.

High-Density Lipoprotein Cholesterol, High-Density Lipoprotein Particle Size, and Apolipoprotein A-1: Significance for Cardiovascular Risk
High-Density Lipoprotein Cholesterol, High-Density Lipoprotein Particle Size, and Apolipoprotein A-1: Significance for Cardiovascular RiskAlthough HDL-C is typically thought of as beneficial, a post-hoc analysis of data from two major studies—IDEAL and EPIC—suggests that at very high levels, it may actually increase the risk of coronary artery disease. In the IDEAL study, after adjustment for apolipoprotein A-I and apolipoprotien B, each standard deviation-increase in HDLC (11.9 mg/dL) raised the risk of a major coronary event by 21%. Data from the EPIC trial showed that HDL particle size was significantly positively related with a major coronary event (OR 1.23, p =0.005). On the other hand, high plasma levels of apoA-1 did not appear to confer increased risk in any model. An abstract of the study was published in the Journal of the American College of Cardiology.

Prognostic Value of Serial CRP Measurements in Left-Sided Native Valve Endocarditis
CRP measurements as well as changes in concentrations of the biomarker after a week of antimicrobial therapy in patients with native-valve endocarditis are strong predictors of poor outcomes, including death or major infection-related complications, concludes a prospective observational study published in the Archives of Internal Medicine. After a week of therapy, the adjusted odds ratio for poor outcome was 10.3 (95% CI, 2.2–49.4) for patients with CRP levels greater than 122 mg/dL versus those with CRP levels of 69 mg/dL or less. A decline in CRP levels also signified increased risk of poor outcome.