International Circulation: What about any new strategies that you’re seeing， perhaps related to biomarkers or new basic research in the prevention of cardiovascular disease. What have you seen that’s new in that area?

    《国际循环》：在心血管疾病预防中，您如何看待有关生物标志物的一些新策略？

    Dr Philip Greenland:So that’s a good question. I mean I think that what is worth thinking about is that many of the biomarkers that we’ve been looking at， and we heard this in the session as well， many of the biomarkers， like say C-reactive protein， it’s very strongly correlated with existing markers that are already in the Predicta model， so the likelihood of something that’s so strongly correlated with the other biomarkers really significantly improving risk estimation is almost doomed to begin with， so this is where we need to be thinking about things that are different from the traditional marker. I think Dr Lloyd Jones pointed it out in the session， that’s why coronary calcium may be having such an impact because it’s a different way of looking at the risk. I think there may be other ways of looking at the risk ， and whether some of the Omics type biomarkers， whether something in either the Metabilom or Protium --something that might be even more proximal to the event -- a lot of these risk factors that we looked at in the session were things that were measured 5 years ago， 10 years ago， but might be very interesting to know whether things that look， that actually change within， say， a year of the vent， 6 months of the event. There’s very little research on that. I think it’s another rather promising area.

    Philip Greenland教授：值得思考的问题是，很多我们一直在观察的生物标志物如C反应蛋白与标准预测模型中目前已有的标志物呈强相关。与其他生物标志物呈如此强相关的某物显著改善风险评估的可能性几乎是注定从此开始。因此，这是我们对不同于传统标记物的事物所需要思考的地方。那是为何冠状动脉钙化积分可能会有如此影响的原因，因为它是看待风险的一种不同的方法。我认为可能有其他的方法，包括某些“组学”型生物标志物，无论代谢组、蛋白质组或其他组中的某种标记是否可能与事件更接近。在事件发生前1年或6个月情况是否发生实质性改变亦可能是令人非常感兴趣想了解的问题。有关此方面的研究尚很少，我认为这是另一个相当有前景的领域。

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