Risk Factors and Biomarkers for Cardiovascular Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 21440

Special Issue Editors


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Guest Editor
Department of Pathophysiology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
Interests: cardiovascular diseases; metabolic diseases; diabetes mellitus; hypercoagulability; antioxidants
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: cardiovascular disease; atherosclerosis; arterial thrombosis; venous thrombosis; anticoagulants; hereditary thrombophilia; inflammation
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Pathophysiology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
Interests: cardiovascular diseases; hypercoagulability; acute cardiac care; noninvasive cardiovascular imaging techniques
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular disease is still the leading cause of morbidity and mortality worldwide despite the great diagnostic and therapeutic progress made in recent decades. The intervention on cardiovascular risk factors is seen as the best long-term solution to improve the outcome of these patients. Therefore, their identification and appropriate therapeutic approach are of the utmost importance.

Some of them are behavioural risk factors, such as unhealthy diet, physical inactivity, tobacco use, and excessive alcohol consumption. Although it is not difficult to correct them, their prevalence remains high because the population is not fully aware of their harmful effect on health. The continuous and long-term action of behavioural risk factors is associated with overweight and obesity, atherogenic dyslipidemia, diabetes, and hypertension, all of which are strong risk factors for cardiovascular disease. The risk of stroke, ischemic heart disease, peripheral artery disease, heart failure, and death that an individual has, increases exponentially as risk factors accumulate because they potentiate each other and accelerate target organ damage.

Although there are many different risk factors that increase the likelihood of developing  cardiovascular disease, they are largely preventable. By implementing a healthy lifestyle and appropriate pharmacological intervention, we can improve the longevity and quality of life of millions of people around the world.

We invite you to share your knowledge and experience. Original and review papers that address cardiovascular risk factors in all aspects, from cellular and molecular mechanisms, and pathophysiological links to problems of diagnosis, treatment, and monitoring are welcome. Only a strong team can have results that matter!

Prof. Dr. Manuela Ciocoiu
Dr. Minerva Codruta Badescu
Dr. Iris Bararu-Bojan
Guest Editors

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Keywords

  • cardiovascular risk factors
  • hypertension
  • dyslipidemia
  • overweight
  • obesity
  • diabetes mellitus
  • metabolic syndrome
  • atherosclerosis
  • physical inactivity
  • biomarkers
  • cardiovascular disease

Published Papers (10 papers)

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Research

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15 pages, 1748 KiB  
Article
Biomarkers for Premature Coronary Artery Disease (PCAD): A Case Control Study
by Muhammad Faizan A. Shukor, Qurratu Aini Musthafa, Yasmin Anum Mohd Yusof, Wan Zurinah Wan Ngah and Noor Akmal Shareela Ismail
Diagnostics 2023, 13(2), 188; https://doi.org/10.3390/diagnostics13020188 - 4 Jan 2023
Cited by 5 | Viewed by 2740
Abstract
Coronary artery disease (CAD) is often associated with the older generation. However, in recent years, there is an increasing trend in the prevalence of CAD among the younger population; this is known as premature CAD. Although biomarkers for CAD have been established, there [...] Read more.
Coronary artery disease (CAD) is often associated with the older generation. However, in recent years, there is an increasing trend in the prevalence of CAD among the younger population; this is known as premature CAD. Although biomarkers for CAD have been established, there are limited studies focusing on premature CAD especially among the Malay male population. Thus, the aim of this research was to compare the biomarkers between premature CAD (PCAD) and older CAD (OCAD) among Malay males. Subjects, recruited from the Universiti Kebangsaan Malaysia Medical Centre and National Heart Institution, were divided into four groups: healthy control < 45 years old; premature CAD (PCAD) < 45 years old; healthy control > 60 years old; and older CAD (OCAD) > 60 years old, with n = 30 for each group. Ten potential markers for CAD including soluble sVCAM-1, sICAM-1, interleukin-2, interleukin-6, interleukin-10, Apo-E and Apo-A1, homocysteine, CRP, and vitamin D levels were examined. Our results revealed premature CAD patients had significantly higher values (p < 0.05) of sVCAM-1, CRP, interleukin-6, and vitamin D when compared to the age-matched controls. Similarly, older CAD patients showed higher levels of sVCAM-1, CRP, and interleukin-2 when compared to their age-matched controls. After adjusting for multiple parameters, only CRP remained significant for PCAD and interleukin-2 remained significant for CAD. This indicates that premature CAD and older CAD patients showed different profiles of protein biomarkers. CRP has the potential to become a biomarker for premature CAD while interleukin-2 is a better biomarker for older CAD together with other typical panels of protein biomarkers. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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13 pages, 536 KiB  
Article
Cardiovascular Comorbidities in Relation to the Functional Status and Vitamin D Levels in Elderly Patients with Dementia
by Violeta Diana Oprea, Mihai Marinescu, Corina Rișcă Popazu, Fabiola Sârbu, Gelu Onose and Aurelia Romila
Diagnostics 2022, 12(12), 2994; https://doi.org/10.3390/diagnostics12122994 - 30 Nov 2022
Cited by 3 | Viewed by 1343
Abstract
(1) Background: As dementia is an incurable, multifactorial neurodegenerative disease, we gathered and analyzed a number of patient characteristics, assessing possible correlations that may support early diagnosis and a more accurate prognosis for cognitively impaired patients. (2) Methods: We used standard clinical parameters [...] Read more.
(1) Background: As dementia is an incurable, multifactorial neurodegenerative disease, we gathered and analyzed a number of patient characteristics, assessing possible correlations that may support early diagnosis and a more accurate prognosis for cognitively impaired patients. (2) Methods: We used standard clinical parameters (cognitive and functional status, comorbidities, and plasma vitamin D levels) in a study group of 162 patients aged above 55 years old. (3) Results: We reported a higher incidence of cardiovascular and metabolic comorbidities in patients with severe or moderate cognitive impairment; a validated correlation between functional status, cognitive status, and serum vitamin D levels; and a more frequently associated profile of neurologic comorbidities in patients with a more significant cognitive deficiency. (4) Conclusions: The present research adds data on the significant correlations of cognitive deficits with cardiovascular, metabolic, and neurologic diseases (and the lack of correlation with osteoarticular illness). Clinicians should make the best use of the current screening and assessment tools (such as the functional scoring of daily activities, cognitive evaluation, and the screening of risk factors). Our data may offer starting points for future in-depth analysis of dementia-modifiable risk factors. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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12 pages, 1539 KiB  
Article
Epicardial Adipose Tissue Thickness Is Related to Plaque Composition in Coronary Artery Disease
by Soon Sang Park, Jisung Jung, Gary S. Mintz, Uram Jin, Jin-Sun Park, Bumhee Park, Han-Bit Shin, Kyoung-Woo Seo, Hyoung-Mo Yang, Hong-Seok Lim, Byoung-Joo Choi, Myeong-Ho Yoon, Joon-Han Shin, Seung-Jea Tahk and So-Yeon Choi
Diagnostics 2022, 12(11), 2836; https://doi.org/10.3390/diagnostics12112836 - 17 Nov 2022
Cited by 6 | Viewed by 1897
Abstract
(1) Background: Currently, limited data are available regarding the relationship between epicardial fat and plaque composition. The aim of this study was to assess the relationship between visceral fat surrounding the heart and the lipid core burden in patients with coronary artery diseases; [...] Read more.
(1) Background: Currently, limited data are available regarding the relationship between epicardial fat and plaque composition. The aim of this study was to assess the relationship between visceral fat surrounding the heart and the lipid core burden in patients with coronary artery diseases; (2) Methods: Overall, 331 patients undergoing coronary angiography with combined near-infrared spectroscopy and intravascular ultrasound imaging were evaluated for epicardial adipose tissue (EAT) thickness using transthoracic echocardiography. Patients were divided into thick EAT and thin EAT groups according to the median value; (3) Results: There was a positive correlation between EAT thickness and maxLCBI4mm, and maxLCBI4mm was significantly higher in the thick EAT group compared to the thin EAT group (437 vs. 293, p < 0.001). EAT thickness was an independent predictor of maxLCBI4mm ≥ 400 along with age, low-density lipoprotein-cholesterol level, acute coronary syndrome presentation, and plaque burden in a multiple linear regression model. Receiver operating characteristic curve analysis showed that EAT thickness was a predictor for maxLCBI4mm ≥ 400; (4) Conclusions: In the present study, EAT thickness is related to the lipid core burden assessed by NIRS-IVUS in patients with CAD which suggests that EAT may affect the stability of the plaques in coronary arteries. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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13 pages, 967 KiB  
Article
Mortality Risk Assessment in Peripheral Arterial Disease—The Burden of Cardiovascular Risk Factors over the Years: A Single Center’s Experience
by Viviana Aursulesei Onofrei, Alexandr Ceasovschih, Dragos Traian Marius Marcu, Cristina Andreea Adam, Ovidiu Mitu and Florin Mitu
Diagnostics 2022, 12(10), 2499; https://doi.org/10.3390/diagnostics12102499 - 15 Oct 2022
Cited by 10 | Viewed by 1550
Abstract
Atherosclerosis is the basis of the cardiovascular continuum in peripheral artery disease (PAD) patients. Limiting functional decline and increasing quality of life are the main objectives for these patients. We conducted a prospective cohort study on 101 patients with PAD admitted to a [...] Read more.
Atherosclerosis is the basis of the cardiovascular continuum in peripheral artery disease (PAD) patients. Limiting functional decline and increasing quality of life are the main objectives for these patients. We conducted a prospective cohort study on 101 patients with PAD admitted to a single center in Northeast Romania. We used an index score to evaluate the 10-year mortality risk assessment and based on the scores we divided the patients into two groups: a low and low-intermediate risk mortality group (49 cases, 48.5%) and a high-intermediate and high-risk mortality group (52 cases, 51.5%). We analyzed demographics, comorbidities, clinical and paraclinical parameters and we aimed to identify the parameters associated with an unfavorable prognosis. Patients in the high-intermediate and high-risk mortality group were associated more with cardiovascular risk factors. Hypertension (p = 0.046), dyslipidemia (p < 0.001), diabetes mellitus (p < 0.001), and tobacco use (p = 0.018) were statistically significant factors. Lipid profile (low-density lipoprotein cholesterol, p = 0.005) and fasting blood glucose (p = 0.013) had higher mean serum values in the high-intermediate and high-risk mortality group, with a positive correlation between them and the ankle-brachial index value (p = 0.003). A multidisciplinary assessment and, especially, correction of associated cardiovascular risk factors prevent complications, and thus, improve the prognosis in the medium and long term. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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11 pages, 900 KiB  
Article
Association of the rs17574 DPP4 Polymorphism with Premature Coronary Artery Disease in Diabetic Patients: Results from the Cohort of the GEA Mexican Study
by Gilberto Vargas-Alarcón, Maria del Carmen González-Salazar, Adrian Hernández-Díaz Couder, Fausto Sánchez-Muñoz, Julian Ramírez-Bello, José Manuel Rodríguez-Pérez and Rosalinda Posadas-Sánchez
Diagnostics 2022, 12(7), 1716; https://doi.org/10.3390/diagnostics12071716 - 15 Jul 2022
Cited by 1 | Viewed by 1499
Abstract
Previously, it has been reported that hypoalphalipoproteinemia (HA) is associated with rs17574 DDP4 polymorphism. Considering that in diabetic patients, HA is often present and is a risk factor for premature coronary artery disease (pCAD), the study aimed to evaluate the association of this [...] Read more.
Previously, it has been reported that hypoalphalipoproteinemia (HA) is associated with rs17574 DDP4 polymorphism. Considering that in diabetic patients, HA is often present and is a risk factor for premature coronary artery disease (pCAD), the study aimed to evaluate the association of this polymorphism with pCAD in diabetic individuals. We genotyped the rs17574 polymorphism in 405 pCAD patients with T2DM, 736 without T2DM, and 852 normoglycemic individuals without pCAD and T2DM as controls. Serum DPP4 concentration was available in 818 controls, 669 pCAD without T2DM, and 339 pCAD with T2DM. The rs17574 polymorphism was associated with lower risk of pCAD (padditive = 0.007; pdominant = 0.003, pheterozygote = 0.003, pcodominant1 = 0.003). In pCAD with T2DM patients, DPP4 levels were lower when compared with controls (p < 0.001). In the whole sample, individuals with the rs17574 GG genotype have the lowest protein levels compared with AG and AA (p = 0.039) carriers. However, when the same analysis was repeated separately in all groups, a significant difference was observed in the pCAD with T2DM patients; carriers of the GG genotype had the lowest protein levels compared with AG and AA (p = 0.037) genotypes. Our results suggest that in diabetic patients, the rs17574G DPP4 allele could be considered as a protective genetic marker for pCAD. DPP4 concentrations were lower in the diabetic pCAD patients, and the rs17574GG carriers had the lowest protein levels. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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Review

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13 pages, 1062 KiB  
Review
Thromboembolic Disease in Haemophilic Patients Undergoing Major Orthopaedic Surgery: Is Thromboprophylaxis Mandatory?
by Oana Viola Badulescu, Iris Bararu Bojan, Minerva Codruta Badescu, Nina Filip, Alina Chelsău, Manuela Ciocoiu, Maria Vladeanu, Alexandru Filip, Norin Forna, Mihnea Theodor Sirbu, Carmen Ungureanu and Paul-Dan Sîrbu
Diagnostics 2023, 13(1), 13; https://doi.org/10.3390/diagnostics13010013 - 21 Dec 2022
Cited by 3 | Viewed by 1518
Abstract
Haemophilia is a rare genetic disorder, that results from various degrees of deficiency of coagulation factor VIII (haemophilia A), or factor IX (haemophilia B), with an X-linked transmission. The patients affected are in the majority of cases males (who inherit the affected X-chromosome [...] Read more.
Haemophilia is a rare genetic disorder, that results from various degrees of deficiency of coagulation factor VIII (haemophilia A), or factor IX (haemophilia B), with an X-linked transmission. The patients affected are in the majority of cases males (who inherit the affected X-chromosome from the maternal side), with rare cases of females with haemophilia (FVIII or FIX < 40 IU/dL), situations in which both X-chromosomes are affected, or one is affected, and the other one is inactive (known as carrier). The hypocoagulable state due to the deficiency of clotting factors, manifests as an excessive, recurrent tendency to bleeding, which positively correlates with plasmatic levels. Severe haemophilia results in hemarthrosis, although recent data have shown that moderate or even mild disease can lead to joint bleeding. Recurrent episodes of haemorrhages, usually affecting large joints such as knees, elbows, or ankles, lead to joint remodelling and subsequent haemophilic arthropathy, which may require arthroplasty as a last therapeutic option. Orthopaedic patients have the highest risk among all for deep vein thrombosis (DVT) and venous thromboembolism (VTE) with morbid and potentially fatal consequences. While for the rest of the population thromboprophylaxis in orthopaedic surgery is efficient, relatively safe, and widely used, for patients with haemophilia who are considered to have a low thromboembolic risk, there is great controversy. The great heterogeneity of this particular population, and the lack of clinical trials, with only case reports or observational studies, makes thromboprophylaxis in major orthopaedic surgery a tool to be used by every clinician based on experience and case particularities. This review aims to briefly summarise the latest clinical data and to offer an insight into the current recommendations that readers would find useful in daily practice. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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15 pages, 710 KiB  
Review
SARS-CoV-2 Infection: What Is Currently Known about Homocysteine Involvement?
by Nina Filip, Elena Cojocaru, Oana Viola Badulescu, Andreea Clim, Alin Constantin Pinzariu, Gabriela Bordeianu, Alina Elena Jehac, Cristina Elena Iancu, Cristiana Filip, Minela Aida Maranduca, Ivona Andreea Sova and Ionela Lacramioara Serban
Diagnostics 2023, 13(1), 10; https://doi.org/10.3390/diagnostics13010010 - 21 Dec 2022
Viewed by 2451
Abstract
Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world causing health, social and economic instability. The severity and prognosis of patients with SARS-CoV-2 infection are associated with the presence of comorbidities such as cardiovascular disease, hypertension, [...] Read more.
Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world causing health, social and economic instability. The severity and prognosis of patients with SARS-CoV-2 infection are associated with the presence of comorbidities such as cardiovascular disease, hypertension, chronic lung disease, cerebrovascular disease, diabetes, chronic kidney disease, and malignancy. Thrombosis is one of the most serious complications that can occur in patients with COVID-19. Homocysteine is a non-proteinogenic α-amino acid considered a potential marker of thrombotic diseases. Our review aims to provide an updated analysis of the data on the involvement of homocysteine in COVID-19 to highlight the correlation of this amino acid with disease severity and the possible mechanisms by which it intervenes. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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19 pages, 371 KiB  
Review
Circulating Biomarkers for Laboratory Diagnostics of Atherosclerosis—Literature Review
by Gabriela Bordeianu, Ivona Mitu, Raluca Stefania Stanescu, Corina Paraschiva Ciobanu, Elena Petrescu-Danila, Afrodita Doina Marculescu and Daniela Cristina Dimitriu
Diagnostics 2022, 12(12), 3141; https://doi.org/10.3390/diagnostics12123141 - 13 Dec 2022
Cited by 1 | Viewed by 1415
Abstract
Atherosclerosis is still considered a disease burden with long-term damaging processes towards the cardiovascular system. Evaluation of atherosclerotic stages requires the use of independent markers such as those already considered traditional, that remain the main therapeutic target for patients with atherosclerosis, together with [...] Read more.
Atherosclerosis is still considered a disease burden with long-term damaging processes towards the cardiovascular system. Evaluation of atherosclerotic stages requires the use of independent markers such as those already considered traditional, that remain the main therapeutic target for patients with atherosclerosis, together with emerging biomarkers. The challenge is finding models of predictive markers that are particularly tailored to detect and evaluate the evolution of incipient vascular lesions. Important advances have been made in this field, resulting in a more comprehensible and stronger linkage between the lipidic profile and the continuous inflammatory process. In this paper, we analysed the most recent data from the literature studying the molecular mechanisms of biomarkers and their involvement in the cascade of events that occur in the pathophysiology of atherosclerosis. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
23 pages, 429 KiB  
Review
Biomarkers in Pulmonary Arterial Hypertension
by Silvana Elena Hojda, Irina Camelia Chis and Simona Clichici
Diagnostics 2022, 12(12), 3033; https://doi.org/10.3390/diagnostics12123033 - 3 Dec 2022
Cited by 4 | Viewed by 2728
Abstract
Pulmonary arterial hypertension (PAH) is a severe medical condition characterized by elevated pulmonary vascular resistance (PVR), right ventricular (RV) failure, and death in the absence of appropriate treatment. The progression and prognosis are strictly related to the etiology, biochemical parameters, and treatment response. [...] Read more.
Pulmonary arterial hypertension (PAH) is a severe medical condition characterized by elevated pulmonary vascular resistance (PVR), right ventricular (RV) failure, and death in the absence of appropriate treatment. The progression and prognosis are strictly related to the etiology, biochemical parameters, and treatment response. The gold-standard test remains right-sided heart catheterization, but dynamic monitoring of systolic pressure in the pulmonary artery is performed using echocardiography. However, simple and easily accessible non-invasive assays are also required in order to monitor this pathology. In addition, research in this area is in continuous development. In recent years, more and more biomarkers have been studied and included in clinical guidelines. These biomarkers can be categorized based on their associations with inflammation, endothelial cell dysfunction, cardiac fibrosis, oxidative stress, and metabolic disorders. Moreover, biomarkers can be easily detected in blood and urine and correlated with disease severity, playing an important role in diagnosis, prognosis, and disease progression. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)

Other

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35 pages, 2904 KiB  
Systematic Review
Genetic Factors for Coronary Heart Disease and Their Mechanisms: A Meta-Analysis and Comprehensive Review of Common Variants from Genome-Wide Association Studies
by Khairul Anwar Zarkasi, Noraidatulakma Abdullah, Nor Azian Abdul Murad, Norfazilah Ahmad and Rahman Jamal
Diagnostics 2022, 12(10), 2561; https://doi.org/10.3390/diagnostics12102561 - 21 Oct 2022
Cited by 2 | Viewed by 2771
Abstract
Genome-wide association studies (GWAS) have discovered 163 loci related to coronary heart disease (CHD). Most GWAS have emphasized pathways related to single-nucleotide polymorphisms (SNPs) that reached genome-wide significance in their reports, while identification of CHD pathways based on the combination of all published [...] Read more.
Genome-wide association studies (GWAS) have discovered 163 loci related to coronary heart disease (CHD). Most GWAS have emphasized pathways related to single-nucleotide polymorphisms (SNPs) that reached genome-wide significance in their reports, while identification of CHD pathways based on the combination of all published GWAS involving various ethnicities has yet to be performed. We conducted a systematic search for articles with comprehensive GWAS data in the GWAS Catalog and PubMed, followed by a meta-analysis of the top recurring SNPs from ≥2 different articles using random or fixed-effect models according to Cochran Q and I2 statistics, and pathway enrichment analysis. Meta-analyses showed significance for 265 of 309 recurring SNPs. Enrichment analysis returned 107 significant pathways, including lipoprotein and lipid metabolisms (rs7412, rs6511720, rs11591147, rs1412444, rs11172113, rs11057830, rs4299376), atherogenesis (rs7500448, rs6504218, rs3918226, rs7623687), shared cardiovascular pathways (rs72689147, rs1800449, rs7568458), diabetes-related pathways (rs200787930, rs12146487, rs6129767), hepatitis C virus infection/hepatocellular carcinoma (rs73045269/rs8108632, rs56062135, rs188378669, rs4845625, rs11838776), and miR-29b-3p pathways (rs116843064, rs11617955, rs146092501, rs11838776, rs73045269/rs8108632). In this meta-analysis, the identification of various genetic factors and their associated pathways associated with CHD denotes the complexity of the disease. This provides an opportunity for the future development of novel CHD genetic risk scores relevant to personalized and precision medicine. Full article
(This article belongs to the Special Issue Risk Factors and Biomarkers for Cardiovascular Disease)
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