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Nephrol Dial Transplant (2004) 19: 761-765
Nephrol Dial Transplant Vol. 19 No. 4 © ERA-EDTA 2004; all rights reserved

Editorial Comment

Is there a need for novel cardiovascular risk factors?

Arnold von Eckardstein

Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland

Correspondence and offprint requests to: A. von Eckardstein, Institute of Clinical Chemistry, University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland. Email: arnold.voneckardstein@ikc.usz.ch

Keywords: coronary heart disease; C-reactive protein; fibrinogen; homocysteine; lipoprotein(a); microalbuminuria; risk factor

The first 150 words of the full text of this article appear below.



   Introduction
 
Atherosclerosis is a multifactorial disease whose age of onset and progression are strongly influenced by inborn and acquired risk factors. Since the pioneering work of the Framingham study, many prospective population and clinical studies have identified a series of independent risk factors for myocardial infarction, stroke and peripheral vascular disease, among which the pre-existence of atherosclerotic vascular disease, age, male gender, a positive family history of premature atherosclerotic disease, smoking, diabetes mellitus, hypertension, hypercholesterolaemia, hypertriglyceridaemia and low HDL cholesterol are considered as classical risk factors. Moreover, several large randomized and prospective intervention studies have demonstrated that smoking cessation as well as anti-hypertensive and lipid-lowering drug therapies help to reduce cardiovascular morbidity and mortality by ~30% in both secondary and primary prevention. Despite these advances, we currently witness a controversy concerning the introduction of novel risk factors into clinical practice, specifically lipoprotein(a) [Lp(a)], C-reactive protein (CRP), fibrinogen, homocysteine and microalbuminuria.



   Advances and limitations of classical risk factors and global risk estimation
 
Two . . . [Full Text of this Article]



   Requirements for novel risk factors
 


   Lipoprotein(a) [11]
 


   C-reactive protein [19]
 


   Fibrinogen [24]
 


   Homocysteine [26]
 


   Microalbuminuria
 


   Conclusion
 

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