Circulating biomarkers play a major role in risk stratification of patients with cardiovascular disease. The 3 most widely used cardiovascular biomarkers—troponin, C-reactive protein, and B-type natriuretic peptide—have each been shown to predict risk of major adverse cardiovascular outcomes beyond traditional clinical factors, and for that reason, use of these biomarkers is recommended in various practice guidelines.
How then should additional biomarkers be added to the clinical armamentarium? The traditional approach has been for candidate biomarkers to emerge from preclinical or pilot clinical data and then be tested individually in progressively larger cohorts that typically involve thousands of patients. This serial approach is slow and requires the development of dedicated assays, typically immunoassays, to detect each biomarker of interest. Multiplexed immunoassays have been developed but typically are constrained by interference between antibodies, proteins, and assay diluents, leading to degradations in accuracy that limit the number of simultaneous assays.1
Sabatine MS. Using Aptamer-Based Technology to Probe the Plasma Proteome for Cardiovascular Disease Prediction. JAMA. 2016;315(23):2525–2526. doi:10.1001/jama.2016.6110