Biochemical Assessment of Risk Factors in Coronary Artery Disease (CAD) Patients: A Comprehensive Review

Abstract

Coronary artery disease (CAD) remains one of the leading causes of mortality and morbidity worldwide. The disease primarily develops due to atherosclerosis, a chronic inflammatory condition characterized by endothelial dysfunction, lipid accumulation, oxidative stress, thrombosis, and vascular inflammation. Biochemical markers play a crucial role in the early diagnosis, risk stratification, prognosis, and therapeutic monitoring of CAD. This review comprehensively evaluates traditional and emerging biochemical risk factors associated with CAD, including lipid profile abnormalities, inflammatory markers, cardiac biomarkers, glycemic indicators, renal biomarkers, coagulation factors, electrolytes, and novel genetic markers. Traditional lipid parameters such as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and total cholesterol remain central to cardiovascular risk assessment. Inflammatory markers including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) provide insight into vascular inflammation and plaque instability. Cardiac biomarkers such as troponins, CK-MB, BNP, and NT-proBNP are essential for myocardial injury detection and prognosis. Emerging biomarkers including lipoprotein(a), homocysteine, genomic markers, and omics-based approaches are increasingly contributing to personalized cardiovascular medicine. The review also discusses current risk prediction models, limitations of biomarker interpretation, controversies in clinical application, and future perspectives involving artificial intelligence and precision medicine. Current evidence supports a multi-marker approach integrating biochemical, clinical, imaging, and genetic data for comprehensive CAD management.