Stroke is a multifactorial event, resulting from the combination of genetic and environmental determinants. The first are more influent in younger patients, while the importance of the environmental factors increase with the age of patients. Biomarkers are thus needed, especially in older individuals, to define the current risk, as it results from the individual combination of genetic predisposition, environmental exposure, and clinical history. The presence of atherosclerosis is a major cause of stroke. The well established risk factors for atherosclerosis (e.g. dyslipidaemia, hypertension, diabetes, obesity) allow the identification of patients at higher risk of vascular events, nevertheless, a large proportion of events still occur, even in patients apparently at low risk. Thus new biomarkers are needed to better identify high-risk patients, and to achieve further insights into the pathogenesis of stroke and its causative conditions. In the first part of this chapter, inflammation, thrombosis, oxidative stress are discussed as possible source of biomarkers of plaque progression and destabilization. In the second part, serum gamma-glutamyltransferase is presented as novel marker for cardiovascular prognosis related to atherosclerosis.
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