Cardiac biomarkers: past, present, and future

Area of Science:

• Cardiology
• Biomarker Discovery

Background:

• Accurate diagnosis of myocardial infarction (MI) is vital for preserving heart function and patient survival.
• Traditional cardiac enzyme measurements (creatine kinase, lactate dehydrogenase) can be inaccurate, especially with co-existing conditions.
• Alternative biomarkers offer improved diagnostic potential for acute coronary syndrome (ACS) and MI.

Purpose of the Study:

• To review the clinical utility of various cardiac biomarkers for diagnosing acute myocardial infarction.
• To highlight the advantages, disadvantages, and appropriate timing for using different cardiac biomarkers.
• To emphasize essential considerations for biomarker selection and interpretation in clinical practice.

Main Methods:

• Review of current literature on cardiac biomarkers for MI diagnosis.
• Analysis of the diagnostic performance of established and novel biomarkers.
• Discussion of clinical guidelines and practical considerations for biomarker utilization.

Main Results:

• Established cardiac enzymes may lack accuracy in complex patient cases.
• Novel biomarkers including creatine kinase mass, cardiac troponins, and myoglobin show clinical usefulness in diagnosing ACS and MI.
• No current biomarker can detect myocardial ischemia; serial testing is essential for all.

Conclusions:

• Cardiac troponins and myoglobin are valuable additions to the diagnostic toolkit for MI.
• Biomarker choice depends on healthcare facility capabilities and patient presentation.
• Serial biomarker testing and consideration of patient symptoms are critical for accurate MI diagnosis.