Acute Coronary Syndromes
This chapter reviews existing information about the genetics and genomics of acute coronary syndromes (ACS), examines protein-based biomarkers and their combinations as an example of the forerunner of clinical proteomics, and conducts an examination of the potential applications of "omic" techniques for refinement of diagnosis, risk stratification, and management of ACS in the future. Despite its common occurrence and severe consequences, the exact molecular mechanisms that trigger an ACS are not fully elucidated. The prognostic tools to identify individuals who are at risk for a first or subsequent ACS event are limited. RNA expression profiling using microrarray technology is shown to accurately classify both the presence and severity of atherosclerotic lesions in aortic tissue, and to identify genes potentially involved in plaque rupture, a pathophysiological precursor to the clinical syndrome of ACS. Since access to tissue is challenging for screening, diagnosis, or prognostic testing in ACS, gene expression profiling from circulating monocytes and peripheral blood leukocytes correlates with the extent of carotid vascular disease, suggesting that blood can be used as a reporter tissue for events occurring in the vessel wall. © 2010 Copyright © 2010 Elsevier Inc. All rights reserved.
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