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Biomarkers and acute coronary syndromes: an update

Christian Mueller1

  • 1Department of Cardiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.

European Heart Journal
|December 21, 2013
PubMed

Insights

Biomarkers, including cardiac troponin (cTn), aid in diagnosing acute coronary syndrome (ACS). High-sensitivity cTn assays improve diagnostic accuracy, enhancing understanding of ACS components like myocardial infarction and unstable angina.

Area of Science:

  • Cardiology
  • Clinical Chemistry

Background:

  • Biomarkers are crucial for diagnosing and managing acute coronary syndrome (ACS), complementing clinical assessment and ECG.
  • Cardiac troponin (cTn) I or T is the established preferred biomarker for ACS.
  • Uncertainties persist regarding high-sensitivity cTn assays, optimal timing of measurements, and the role of other biomarkers like copeptin and natriuretic peptides.

Purpose of the Study:

  • To review the diagnostic application of biomarkers in suspected ACS.
  • To address uncertainties surrounding high-sensitivity cTn assays and their clinical utility.
  • To highlight the improved understanding of ACS pathophysiology and incidence due to advanced biomarker assays.

Main Methods:

  • Review of current literature on cardiac biomarkers in ACS diagnosis.
  • Focus on diagnostic applications with immediate therapeutic implications.
  • Discussion of high-sensitivity cardiac troponin (hs-cTn) assays and other relevant biomarkers.

Main Results:

  • High-sensitivity cTn assays offer increased diagnostic accuracy for ACS.
  • These assays enhance the understanding of ACS incidence, pathophysiology, and mortality.
  • The review clarifies the role of biomarkers in risk stratification and management.

Conclusions:

  • Cardiac troponin remains the cornerstone biomarker for ACS diagnosis.
  • High-sensitivity assays are advancing the field, necessitating optimized clinical use strategies.
  • Biomarkers are essential for differentiating ACS components and guiding immediate patient care.

Keywords:
Acute myocardial infarctionCardiac troponinCardiomyocyte injuryCopeptinDiagnosisMyocardial ischaemiaNatriuretic peptides

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