Currently, the existing biomarkers for a cardiac event include B-type natriuretic peptide, tro-ponins and C-reactive protein. C-reactive protein is an acute-phase protein released in response to inflammation.
Recently, the development of a high-sensitivity assay for CRP (hs-CRP) has been made available. The assay works because it can accurately reflect even low levels of CRP. There have been quite a few prospective studies that have shown that an assay of a baseline CRP can be used as a marker for cardiovascular events.
When patients have a test that shows elevated levels, it is even a better marker than LDL cholesterol for predicting events such as myocardial infarction. An elevated test, however, can also mean hypertension, metabolic syndrome or diabetes, or a chronic infection.
In addition, Lipoprotein (a), or Lp(a), when combined with C-reactive protein, can increase the predictive value of a cardiac event. This is especially true for those who have normal cholesterol levels. The reason is that the lipoprotein promotes vascular inflammation that affects the atherogenic process directly.
Pagana, K.D., Pagana, T.J. Mosby's Manual of Diagnostic and Laboratory Tests, 3rd ed. Mosby Elsvier, 2006.