编者按：近年来，随着基因组学，蛋白组学和系统生物学的迅猛进展，大量生物信息的不断涌现，确定心血管疾病生物标志物已成为一种迫切的需求，目前正不断从定义到方法学上规范化。有关生物标志物对心血管疾病的预测价值，《国际循环》编辑部采访到美国波士顿曼彻斯特大学Ernst J. Schaefer教授。

　　International Circulation: Dr. Shepherd， I have some questions about bio-markers to ask you. The first one is that the risk prediction of cardiovascular disease is important for patient intervention. So in additional to the traditional markers， what are the new predictions and strategies have we found in recent years?

　　主要心血管疾病预测标志物

　　S: Well， the marker that people are now started to use in risk prediction in addition to the stairs one will be the C-reactive protein， like protein A is another， and small dense LDL cholesterol is another. So those three markers are grade for heart disease. And as to heart failure， it will be N-terminal Pro Brain Natriuretic Peptide or NT - pro BMP， they are all great markers for heart failure， and treating people to prevent them from having to go the hospital before heart failure.

　　传统的生物标志物包括C反应蛋白样蛋白A和低密度脂蛋白胆固醇（LDL-C）。对心力衰竭患者来说，N-末端脑钠肽前体和N-末端骨形态发生蛋白是重要预测因子，可在患者发病前给出预警。

　　International Circulation: So how to recognize and judge the sensitivity and specificity of these markers?

　　评价生物标志物的敏感性和特异性

　　S: Yeah we do that with something called c statistic and the area under the receiver operated curve， and that is how we predict. And also whether you reclassify risk base time on your marker， for example the family history is also the important question. So I will say family history， C-reactive protein like protein A， and small dense LDL cholesterol will be the next makers that people will be adding; and those actually also being measured here in Beijing， they are in a large population study.

　　除了专业软件外，要根据基线风险水平重新定义标准。如患者有家族史，蛋白A和LDL-C水平需被纳入考虑。目前北京正在进行相关大规模人口学研究。回到临床实践中，如患者的生物标志物呈现显著异常，也意味着需进行更积极的治疗。