Affiliations: From the Duke Clinical Research Institute, Duke
University Medical Center, Durham, NC, USA
Note: [] Corresponding author: L. Kristin Newby, MD, MHS, Duke Clinical
Research Institute, P.O. Box 17969, Durham, NC 27715-7969, USA. Tel.: +1 919
668 8805; Fax: +1 919 668 7056; E-mail: newby001@mc.duke.edu
Abstract: Coronary disease is the leading killer of individuals worldwide and
a leading cause of healthcare expenditure. On a global scale, ischemic heart
disease kills over 6 million individuals each year and is projected by the
World Health Organization to be the greatest single-disease cause of death
worldwide by an increasing margin into 2030. Nearly 17 million Americans
(7.6% of the population) have prevalent coronary heart disease, 8 million of
whom have had a prior myocardial infarction. It is estimated that in 2009,
550,000 will die from coronary heart disease in the United States and that the
direct and indirect costs from treating coronary heart disease will exceed
$165 billion. Although patients with known coronary artery disease are among
the highest risk patients for future cardiac events, not all patients with
coronary disease will have an ischemic event (first or recurrent). Determining
which of these patients will have an ischemic event is critical to the concept
of personalized cardiovascular care. Increasingly, biomarkers that can be
readily assayed from blood or other body fluids will be critical to risk
stratification and effective application of secondary prevention strategies,
just as they have played an increasingly prominent role in risk stratification
of acute coronary syndrome patients.
