Advancing Biomarker Science in the 21st Century

“Do something wonderful, people may imitate it.” — —Albert Schweitzer One of the primary objectives of scientific investigation in medicine is to inform patient care. The creative, imaginative, and intelligent study of advanced biomarkers, including genes, transcripts, proteins, and metabolic byproducts, may hold the key to redefining human disease and achieving optimal clinical outcomes. Given the global interest, overarching relevance, and inherent complexity, the most pertinent question becomes, “what is required of the scientific and medical communities to advance meaningfully the discipline of biomarker science in the 21st century?”Article see p 14 In this issue of the Circulation: Cardiovascular Interventions , Derer et al1 introduce vitronectin as an independent predictor of both early (30-day) and late (6-month) major adverse cardiovascular events after percutaneous coronary intervention (PCI) with or without stenting. Patients with a baseline serum vitronectin level ≥49.7 mg/mL (representing the upper quartile) experienced death, myocardial infarction, or urgent target-vessel revascularization at a 3-fold higher rate than patients in the 3 lower quartiles. Will vitronectin become an established part of the armamentarium for periprocedural risk assessment? Will it one day assume the lofty status of troponin as a readily available and widely implemented measurement tool for clinicians?Cardiac-specific troponin is considered the prototypical biomarker for several reasons. It is detectable in very low concentrations under normal conditions; it increases rapidly, predictably, and for a well-defined duration after myoctye necrosis; and it identifies patients at risk for subsequent cardiovascular events and those in whom antithrombotic pharmacotherapy and PCI offer the greatest benefit. Troponin …