The relationship between cardiovascular disease and other chronic conditions

Cardiovascular disease (CVD) remains the most common cause of mortality and comorbidity all over the world.1 Risk stratification plays an important role in the prevention of the onset of cardiovascular disease and the development of its complications. As CVD is multifactorial, several associated risk factors have long been identified (e.g., smoking habit, improper diet, low physical activity, hypertension, hypercholesterolemia, diabetes) (1). The key question is whether we have enough biomarkers to better stratify CV risk. Although the CV burden is generally featured by these traditional risk factors, the importance of non-traditional biomarkers may be critical to fill the gap related to the so-called “residual risk.” In fact, CV load cannot be entirely explained by traditional cardiovascular risk factors, as many patients at risk for adverse prognosis do not present any of these traditional determinants (2). Such evidence suggests the involvement of possible overlooked non-traditional biomarkers that may play an important role in the pathogenesis and development of CVD (2). Thus, there is an increasing interest for additional biomarkers and risk factors providing potential new tools against CVD onset and progression. Discovery of such factors and, most important, of their mechanism of action, may help in the development of advanced care strategies aiming to the reduction of cardiovascular harmful impact. For example, between biochemical factors, beside the widely employed troponins (ischemic damage) and natriuretic peptides (cardiac stress and dysfunction), it would be important to better clarify the role of already known biomarkers in this new context, such as vitamin D well known for bone health, or other new proposed parameters (e.g., oxidative stress biomarkers, hemoglobin, galectin-3-fibrosis, cystatin-renal dysfunction, cytokines and neutrophils/lymphocytes-inflammation, d-dimer-coagulation).However, despite the best efforts, so far, no reliable applicable additive biomarkers have been identified. A list of all contributions to this special issue is reported in Table 1. Majority of the contributions in this special issue explore the significance of different biomarkers and risk factors in the various CVD manifestations.