Biomarkers and acute coronary syndromes: an update

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.