Laboratory tests and biopsychosocial approach in the examination of patients with brachiocephalic arteries atherosclerosis

Abstract

This article is a literature review aimed at consideration of the ways to increase the effective use of laboratory biomarkers in the context of biopsychosocial approach in patients with atherosclerosis of brachiocephalic arteries. Laboratory markers are a valuable diagnostic tool to evaluate atherosclerotic plaque progression and assess treatment effectiveness. However, according to up to date guidelines only few biomarkers are recommended to routine use in stroke patients. Hence, their analysis does not provide enough information to satisfy diagnostic and therapeutic needs. The parameters of general lipid profile can not serve as a reliable predictor of stroke risk, so we need to find biomarkers more significantly associated with progression of atherosclerosis, atherosclerotic plaque destabilization and stroke risk. Many studies on novel laboratory markers of atherosclerosis (lipoprotein-associated phospholipase A2, high sensitive C reactive protein, lipoprotein (a), pregnancy-associated plasma protein A and asymmetric dimethylarginine) have been performed in the recent years. However, these biomarkers are not included in the guidelines for stroke evaluation due to the lack of sufficient evidence. The published data are very contradictory. History of previous disease, individual characteristics of the patient, lifestyle, vitality, psycho-emotional background and social environment may all have a significant impact on atherosclerosis development and progression due to their influence on molecular mechanisms. Increased use of biopsychosocial approach that takes into account these features will result in better understanding of biochemical processes in patients with atherosclerosis and will contribute to identification of new targets for drug and non-drug treatment. This will provide much more accurate results and more efficient use of laboratory biomarkers in patients with high risk of stroke during their diagnostic evaluation and treatment.