Cardiac biomarkers

Summary

Measurement of serological biomarkers before, during and after percutaneous coronary interventions for stable or acute coronary artery disease allows for insight into various complex pathophysiological processes which are involved in the progression of atherosclerosis and complications of percutaneous coronary interventions. Key to the proper use of biomarkers is an understanding of the fundamental principles of atherosclerosis and the mechanisms potentially involved in the transition from stable disease to spontaneous plaque disruption, as well as the mechanisms behind mechanically induced vessel wall trauma after balloon angioplasty and coronary stenting.

Cardiac troponins are recommended for the diagnosis of spontaneous MI and subtypes of MI, including type 4 MI (post-PCI) and type 5 MI (post-CABG), although there is still controversy regarding the magnitude of concentration rise that is prognostically relevant. New and more sensitive assay generations have been introduced to facilitate earlier and more accurate diagnosis of non-STEMI. These high sensitive cardiac troponin (hs-cTn) assays raise the question whether additional markers of early necrosis, such as myoglobin, ischaemia-modified albumin or heart-type fatty acid binding protein may be omitted. These biomarkers might confer independent information or add to the diagnostic and prognostic information already provided by cardiac troponins.

Biomarkers in acs

PATHOPHYSIOLOGY OF...