Biomarkers and acute coronary syndromes: an update

European Heart Journal
Christian Mueller

Abstract

Biomarkers complement clinical assessment and the 12-lead ECG in the diagnosis, risk stratification, triage, and management of patients with suspected acute coronary syndrome (ACS). While there is broad consensus that cardiac troponin (cTn) I or T is the preferred biomarker in clinical practice, important uncertainties remain regarding the value of high-sensitivity cTn assays, their best clinical use including the most appropriate timing of serial measurements, as well as the added value of other biomarkers reflecting and quantifying other pathophysiological signals including copeptin and natriuretic peptides. This review will address these aspects with a focus on the diagnostic application of biomarkers, as they are associated with immediate therapeutic consequences. In addition, this review will briefly highlight that increased diagnostic accuracy offered by high-sensitivity cTn assays has contributed to improve our understanding of the incidence, pathophysiology, and mortality of the two distinct components currently summarized under the term ACS: acute myocardial infarction and unstable angina.

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Citations

Sep 17, 2014·Biomarkers in Medicine·Louise Balling, Finn Gustafsson
Jan 23, 2016·Annals of Emergency Medicine·Christian MuellerUNKNOWN TRAPID-AMI Investigators
Dec 25, 2015·American Heart Journal·Cedric JaegerChristian Mueller
May 7, 2016·Journal of the American College of Cardiology·Arash MokhtariUlf Ekelund
Jul 6, 2014·Interactive Cardiovascular and Thoracic Surgery·Sven PeterssNawid Khaladj
Apr 4, 2015·The American Journal of Medicine·Maria Rubini GimenezChristian Mueller
May 12, 2015·Disease Markers·Sebastian Johannes ReinstadlerJohannes Mair
Jun 15, 2016·American Heart Journal·Martijn W SmuldersSebastiaan C A M Bekkers
Mar 24, 2016·Current Opinion in Anaesthesiology·Eckhard MauermannGiovanna Lurati Buse
Aug 2, 2016·Heart, Lung & Circulation·Derek P ChewUNKNOWN NHFA/CSANZ ACS Guideline 2016 Executive Working Group:
Nov 9, 2016·American Heart Journal·Karin WildiChristian Mueller
Aug 31, 2016·International Journal of Cardiology·Kris G VargasKurt Huber
Oct 19, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Magdalena KrintusGrazyna Sypniewska
Dec 15, 2016·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·P DammanR J de Winter
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May 2, 2017·Critical Reviews in Clinical Laboratory Sciences·Marek KozinskiGrazyna Sypniewska
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Feb 13, 2019·Critical Pathways in Cardiology·James McCordUNKNOWN TRAPID-AMI Investigators
Dec 14, 2018·Heart·Jeanne du Fay de LavallazUNKNOWN BASEL-PMI Investigators
Apr 6, 2019·Postgraduate Medical Journal·Yuqi ChenXiang Zhou
Jun 22, 2019·European Journal of Heart Failure·Christian MuellerUNKNOWN Heart Failure Association of the European Society of Cardiology
Aug 28, 2014·Current Opinion in Critical Care·Danielle M GualandroChristian Mueller
Aug 3, 2017·Molecular Medicine Reports·Xiaohong YangXiaohui Zheng

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