Affiliations:

For more than 20 years, coronary heart disease and stroke have been the first and third leading causes of death and major causes of disability in the United States and other developed countries (1). These are estimated to be the first and second leading causes of death in the world today and are expected to remain so by the year 2020 (2). Despite significant reduction in all standardized mortality from cardiovascular disease (CVD) over the past 20 years, CVD remains the number one cause of death in the United States, out ranking all cancers by more than 60 % (3). More than 70.1 million Americans have some form of cardiovascular disease (3). Public health priorities for prevention of cardiovascular events and stroke as addressed in Healthy People 2010 are; prevention of risk, detection and treatment of risk factors, early identification and treatment of heart attacks and stroke, and prevention of recurrent cardiovascular events (4,5). Thus the search for biomarkers that will better detect coronary patients with disease who could potentially benefit from intensive primary prevention efforts is critically important. The American Heart Association (6) and the National Cholesterol Education Program’