Clinical Chemistry ’s Hot Topics session at the 70th AACC Annual Scientific Meeting & Clinical Lab Expo in Chicago will explore cardiovascular disease (CVD) biomarkers for risk prediction and therapy optimization.
The popular hot topics sessions are based on highly cited articles in the journal during the past year. This scientific session ( 33108 ) will take place on July 31 from 10:30 a.m. until noon and is worth 1.5 CE hours. “We chose biomarkers of cardiovascular disease because we publish a quite a bit on the topic and it’s of primary interest to our readers,” said Clinical Chemistry editor-in-chief, Nader Rifai, PhD, DABCC.
- Paul Ridker, MD, MPH, director of the Center for Cardiovascular Disease Prevention at Boston-based Brigham and Women’s Hospital, whose talk is on inflammation and CVD, from risk reduction to prevention; and
- Børge Nordestgaard, MD, DMSc, chief physician with the Department of Clinical Biochemistry at Herlev and Gentofte Hospital, Copenhagen University Hospital, who plans to discuss lipoprotein(a) measurement, its association with CVD and diabetes, and new therapies.
Inflammation is an integral component of the development and progression of atherothrombotic disease, and inflammatory markers have been used in risk prediction algorithms. The inflammatory marker C-reactive protein measured via high-sensitivity assay (hs-CRP) has been shown to be useful in optimizing statin therapy in both primary and secondary prevention settings.
“CRP research helped to fundamentally change our understanding of atherosclerosis and demonstrated the role of chronic low grade inflammation in atherogenesis,” said Rifai, adding that the JUPITER trial in 2008 helped to demonstrate that fact. However, since statin therapy affects both lipids and inflammation, the theoretical possibility that the observed findings might have been due to lipid reduction, could not be ruled out.
Now, the recent CANTOS trial has demonstrated that anti-inflammatory therapy, which has no influence on lipids, lowers both hs-CRP and CVD risk. As CLN Stat previously reported, at higher doses, the IL-1β inhibitor canakinumab was found to lower risk of primary endpoint cardiovascular events by 15% at 150 mg and 14% at 300 mg, and secondary endpoint events by 17% overall under these doses. It also led to a 30% reduction in the need for bypass surgery or angioplasty.
“CANTOS established once and for all that when you lower inflammation you lower CVD incidence,” said Rifai. “Paul Ridker is the world authority on this subject and the principle investigator of both trials, so he is the ideal person to tell this story for our audience.”
On the Lp(a) front, recent studies demonstrate an inverse relationship between Lp(a) and diabetes, thus renewing interest in this puzzling analyte. The measurement of Lp(a) has been a challenge, but commercial assays that are not affected by the kringle4 type 2 repeats are now available. In addition, new therapies for lowering Lp(a) and potentially CVD risk are putting this lipoprotein in the spotlight again.
“Lp(a) is seeing a revival in its use as a CVD risk predictor because of new pharmaceutical agents,” said Rifai. “Another interesting observation came from a paper we published by Samia Mora where she demonstrated for the first time an inverse relationship between incident diabetes and Lp(a). In Dec 2017 Børge Nordestgaard published a paper in Clinical Chemistry demonstrating that kringle IV type 2 and not low Lp(a) that is causing diabetes. The biological story is still unfolding but it is a very interesting area of research.”
Don’t miss this timely hot topics session: Register now for the 70th AACC Annual Scientific Meeting & Clinical Lab Expo July 29–August 2 in Chicago.