ABSTRACT
The diagnosis and management of patients with acute coronary syndrome (ACS) have evolved dramatically over the past decade. Biomarkers play an important role in the diagnosis of ACS, especially in unstable angina and non-ST-segment elevation myocardial infarction. Among these, cardiac troponin and creatine kinase appear to be the most sensitive and specific markers of myocardial injury. Recent studies have revealed several novel biomarkers. Elevated levels of C-reactive protein and interleukin-6 are strong independent markers of increased mortality among patients with ACS. However, the ideal biomarkers that offer early detection, risk strati fi cation, selection of therapy, monitoring disease progression, and treatment efficacy remain to be elucidated. This review assesses limitations and contemporary needs for biomarkers in the context of diagnosis of ACS. It also discusses the newly developing technologies for novel biomarkers or novel biomarker protein signatures discovery, and importance of point-of-care testing for future management.
Advances in our understanding of the pathophysiology of acute coronary syndrome (ACS) have led to the marked increase in development of biomarkers for diagnosis, risk stratification, therapeutic decision-making, and assessment of clinical outcomes. Patients with ACS are subdivided into the following 2 major categories based on the 12-lead electrocardiogram (ECG): those with new ST-elevation on the ECG that is diagnostic of acute ST-elevation myocardial infarction (STEMI) and those who present with ST-segment depression, T-wave changes, or no ECG abnormalities [non-ST elevation ACS (NSTEACS)].
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