Abstract
Personalized medicine is partly based on biomarker-guided diagnostics, therapy and prognosis, which is becoming an unavoidable concept in modern cardiology. However, the clinical significance of single biomarker studies is rather limited. A promising novel approach involves combining multiple markers into a multiplex panel, which could refine the management of a particular patient with cardiovascular pathology. Two principally different assay formats have been developed to facilitate simultaneous quantification of multiple antigens: planar array assays and microbead assays. These approaches may help to better evaluate the complexity and dynamic nature of pathologic processes and offer substantial cost and sample savings compared with traditional enzyme-linked immunosorbent assay (ELISA) measurements. However, a multiplex multimarker approach cannot become a generally disseminated method until analytical problems are solved and further studies confirming improved clinical outcomes are accomplished. These drawbacks underlie the fact that a limited number of systematic studies are available regarding the use of a multiplex biomarker approach in cardiovascular medicine to date. Our perspective underscores the significant potential of the use of the multiplex approach in a wider conceptual framework under the close cooperation of clinical and experimental cardiologists, pathophysiologists and biochemists so that the personalized approach based on standardized multimarker testing may improve the management of various cardiovascular pathologies and become a ubiquitous partner of population-derived evidence-based medicine.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
US President's Council of Advisors on Science and Technology (PCAST) Priorities for Personalized Medicine. Washington DC: Executive Office of the President of United States; 2008.
Johnson JA, Cavallari LH. Pharmacogenetics and cardiovascular disease – implication for personalized medicine. Pharmacol Rev 2013; 65: 987–1009.
Adamcova M, Lencova-Popelova O, Jirkovsky E, Mazurova Y, Palicka V, Simko F, et al. Experimental determination of diagnostic window of cardiac troponins in the development of chronic anthracycline cardiotoxicity and estimation of its predictive value. Int J Cardiol 2015; 201: 358–67.
Adamcova M, Popelova-Lencova O, Jirkovsky E, Simko F, Gersl V, Sterba M. Cardiac troponins: Translational biomarkers in cardiology: Theory and practice of cardiac troponin high-sensitivity assays. Biofactors 2016; 42: 133–48.
Taqui S, Daniels LB. Putting it into perspective: multimarker panels for cardiovascular disease risk assessment. Biomark Med 2013; 7: 317–27.
Fu Q, Zhu J, Van Eyk JE. Comparison of multiplex immunoassay platforms. Clin Chem 2010; 56: 314–8.
Adamcova M, Ruzickova S, Simko F. Multiplexed immunoassays for simultaneous quantification of cardiovascular biomarkers in the model of HG-nitro-L-arginine methylester (L-NAME) hypertensive rat. J Physiol Pharmacol 2013; 64: 211–7.
Herman E, Knapton A, Zhang J, Estis J, Todd J, Lipshultz S. The utility of serum biomarkers to detect myocardial alterations induced by Imatinib in rats. Pharmacol Res Perspect 2014; 2: e00015.
Vistnes M, Wæhre A, Nygard S, Sjaastad I, Andersson KB, Husberg C, et al. Circulating cytokine levels in mice with heart failure are etiology dependent. J Appl Physiol 2010; 108: 1357–64.
Lori LD, Maisel AS. Multiple marker approach to risk stratification in patients with stable coronary artery disease: to have or have not. Eur Heart J 2010; 31: 2980–3.
Blankenberg S, Zeller T, Saarela O, Havulinna AS, Kee F, Tunstall-Pedoe H, et al. Contribution of 30 biomarkers to 10-year cardiovascular risk estimation in 2 population cohorts: the Monica, Risk, Genetics, Archiving, and Monograph (MORGAM) biomarker project. Circulation 2010; 121: 2388–97.
Shah RU, Rumsfeld JS. Big data in cardiology. Eur Heart J 2017; 38: 1865–7.
Halim SA, Neely ML, Pieper KS, Shah SH, Kraus WE, Hauser ER, et al. Simultaneous consideration of multiple candidate protein biomarkers for long-term risk for cardiovascular events. Circ Cardiovasc Genet 2015; 8: 168–77.
Gupta DK, Wang TJ. Biomarker discovery: searching for quality in quantity. Circ Cardiovasc Genet 2015; 8: 8–10.
Gerstein HC, Paré G, McQueen MJ, Haenel H, Lee SF, Pogue J, et al. Outcome reduction with initial glargine intervention trial investigators: Identifying novel biomarkers for cardiovascular events or death in people with dysglycemia. Circulation 2015; 132: 2297–304.
de Lemos JA, Rohatgi A, Ayers CR. Applying a big data approach to biomarker discovery: running before we walk? Circulation 2015; 132: 2289–92.
Vistnes M, Hoiseth AD, Rosjo H, Nygard S, Pettersen E, Soyseth V, et al. Lack of pro-inflammatory cytokine mobilization predicts poor prognosis in patients with acute heart failure. Cytokine 2013; 61: 962–9.
Tighe PJ, Ryder RR, Todd I, Fairclough LC. ELISA in the multiplex era : Potentials and pitfalls. Proteomics Clin Appl 2015; 9: 406–22.
Acknowledgements
Supported by the program PROGRES Q 40/5 and grant VEGA 1/0071/15.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Adamcova, M., Šimko, F. Multiplex biomarker approach to cardiovascular diseases. Acta Pharmacol Sin 39, 1068–1072 (2018). https://doi.org/10.1038/aps.2018.29
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/aps.2018.29
Keywords
This article is cited by
-
Integrated bioinformatics and experiment validation reveal cuproptosis-related biomarkers and therapeutic targets in sepsis-induced myocardial dysfunction
BMC Infectious Diseases (2025)
-
DNA-framework-based multidimensional molecular classifiers for cancer diagnosis
Nature Nanotechnology (2023)
-
Use of nCounter mRNA profiling to identify at-arrival gene expression patterns for predicting bovine respiratory disease in beef cattle
BMC Veterinary Research (2022)
-
Love is in the hair: arginine methylation of human hair proteins as novel cardiovascular biomarkers
Amino Acids (2022)
-
The emerging role of circular RNAs in cardiovascular diseases
Journal of Physiology and Biochemistry (2021)
