Cardiac biomarkers in acute coronary syndromes
Keywords:
Acute Coronary Syndromes, cardiac biomarkers, markers of myocardial necrosis, troponin, myoglobin, creatine kinaseAbstract
Proper evaluation of the patient with acute chest pain is a
difficult challenge faced daily by Emergency Room physicians.
Admitting patients with low probability of having an Acute Coronary Syndrome may become unaffordable both financially and
logistically; on the other side of this delicate balance is the risk of misdiagnosis.
Cardiac biomarkers are the third essential element in the
diagnostic approach of Acute Coronary Syndromes, in addition
to clinical symptoms and the results of the electrocardiogram.
The clinical evaluation is often limited by atypical symptoms and
not infrequently the initial electrocardiogram is nondiagnostic.
In these patients with atypical presentations of Acute Coronary
Syndromes the quantification of cardiac biomarkers is particularly important.
The knowledge of the release kinetics of theses substances,
the techniques used to quantify them, their reference values and
their advantages and disadvantages is fundamental in order to
use them adequately in a specific clinical context.
In addition to their utility in the diagnosis or exclusion of acute
myocardial infarction, cardiac biomarkers provide prognostic information (risk stratification) and are helpful in indicating therapeutic strategies for Acute Coronary Syndromes.
This article reviews cardiac biomarkers now available in the hospital practice.
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