In search for novel biomarkers of acute coronary syndrome

Prerequisites for a biomarker to enter clinical routine in acute coronary syndrome (ACS) are several folds. The most important features are that the biomarker can be offered on a routine platform to diagnose and identify high-risk individuals of ACS, provide higher sensitivity and specificity than the ECG in predicting outcome, and should have impact on therapeutic decision making. In recent years, a deeper understanding of the pathobiology of the atherothrombosis as the underlying mechanism of ACS has directed scientific studies towards the evaluation of certain pathogenic components involved in the process as potential biomarkers for the clinical settings of ACS. Under investigations are markers to identify early injury/ischemia, markers for detection of vulnerable plaque, its disruption, of thrombosis and markers for inflammation. The aim of this paper is to review the current contribution of biochemical markers to clinical cardiology and also to discuss some important developments in this field.