Perspective

Multiplex biomarker approach to cardiovascular diseases

Authors: Michaela ADAMCOVA1, Fedor SIMKO2,3,4
1 Department of Physiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
2 Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
3 Third Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
4 Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
Correspondence to: Michaela ADAMCOVA: adamcova@lfhk.cuni.cz,
DOI: 10.1038/aps.2018.29
Received: 4 November 2017
Accepted: 31 January 2018
Advance online: 12 April 2018

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.
Keywords: cardiac biomarkers; multimarker approach; Luminex; planar array assays; microbead assays; cardiac troponins; personalized medicine

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