Usefulness of biomarkers for acute heart disease

Important biomarkers for cardiology:

1 For acute coronary syndromes (unstable angina and heart attacks)

Chest pain is a very common symptom that causes patients to see a doctor often in hospital emergencies and also in medical clinics. In this situation, the diagnosis of heart pain due to a blocked coronary artery is extremely important and should be made at the earliest. EKG is very helpful if it is a full-blown heart attack called ST-segment elevation myocardial infarction (STEMI). These patients need immediate care in a cardiology center or a specialized medical unit capable of administering anticoagulant drugs (Streptokinase or Tenecteplase, etc.).

However, at least 50% of heart attacks do not have a telltale change in the ECG, but they have a partial blockage due to a clot in the heart artery. These are the patients for whom biomarkers are most useful.

Markers of myocardial damage:

CPK and CPK-MB

Creatine kinase (CK) and creatine kinase-MB (CK-MB) have long been the gold standard for the diagnosis of acute myocardial infarction (AMI). CK-MB is an isoenzyme of CK predominantly found in the myocardium. Its elevation occurs 4 to 6 hours after the onset of cardiac injury and remains so for 24 to 48 hours. The higher the level, the greater the damage.

Cardiac troponins (Trop t and Trop i)

Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are more sensitive and specific markers than CK-MB in the detection of myocardial necrosis, and have become the preferred biomarkers for the diagnosis of AMI. They are also a useful prognostic indicator in patients with ACS. The superior clinical performance of troponin results from its higher sensitivity for smaller myocardial damage and is considered the benchmark in the new definition of heart attack. These markers can be used as a qualitative method showing positive or negative using a strip requiring a drop of blood. An additional line appearing within a few minutes indicates damage to the heart muscle. However, this method does not give the quantitative value. Quantitative values ​​are important for obtaining information regarding the severity of muscle damage. Higher values ​​are accompanied by more complications.


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