[Biochemical markers of ischemic and non-ischemic myocardial damage].
BACKGROUND
Biochemical markers have been an integrative part of non-invasive diagnostic strategies in cardiology for nearly 50 years, experiencing a renascence by the recently acknowledged prognostic potential of cardiac troponins in acute coronary syndromes.


METHODS
According to the guidelines of the National Academy of Clinical Biochemistry and the International Federation of Clinical Chemistry cardiac troponin T and cardiac troponin I should be considered as the new "gold markers" of ischemic myocardial injury. One characteristic feature of these new markers is the improved diagnostic potential, reflected by the choice of two cut-off values to distinguish minor myocardial injury from acute myocardial infarction. In addition, cardiac troponins allow risk stratification in the clinical setting of acute coronary syndromes: approximately threefold higher mortality rate for patients with rest angina or ST segment elevation and cardiac troponin elevation on admission. Other indications for cardiac marker analysis are monitoring of therapeutic success in case of invasive and non-invasive reperfusion strategies and non-invasive diagnosis of non-ischemic myocardial injury (myocarditis, cardiac contusion and chemotherapy).


CONCLUSIONS
Biochemical cardiac markers are a useful tool in the diagnosis of both ischemic and non-ischemic myocardial injury. Among these, cardiac troponins seem to become the gold markers for the new millennium.
Herrmann
J
J
Abteilung für Kardiologie, Zentrum für Innere Medizin, Universitätsklinikum Essen.
Volbracht
L
L
Haude
M
M
Eggebrecht
H
H
Malyar
N
N
Mann
K
K
Erbel
R
R
D000789:Angina, Unstable / Q000097:blood / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood*; D009202:Cardiomyopathies / Q000097:blood* / Q000175:diagnosis* / Q000201:enzymology; D002352:Carrier Proteins / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis; D003402:Creatine Kinase / Q000097:blood; D003937:Diagnosis, Differential; D000071438:Fatty Acid-Binding Protein 7; D050556:Fatty Acid-Binding Proteins; D005858:Germany; D006335:Heart Injuries / Q000097:blood / Q000175:diagnosis; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis* / Q000201:enzymology; D009205:Myocarditis / Q000097:blood / Q000175:diagnosis; D009211:Myoglobin / Q000097:blood; D018995:Myosin Heavy Chains / Q000097:blood; D018994:Myosin Light Chains / Q000097:blood; D009363:Neoplasm Proteins; D006005:Phosphorylases / Q000097:blood; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis; D012720:Severity of Illness Index; D019210:Troponin I / Q000097:blood; D020107:Troponin T / Q000097:blood; D025521:Tumor Suppressor Proteins; D018754:Ventricular Dysfunction / Q000097:blood / Q000175:diagnosis
D015415:Biomarkers; D002352:Carrier Proteins; C107608:FABP7 protein, human; D000071438:Fatty Acid-Binding Protein 7; D050556:Fatty Acid-Binding Proteins; D009211:Myoglobin; D018994:Myosin Light Chains; D009363:Neoplasm Proteins; D019210:Troponin I; D020107:Troponin T; D025521:Tumor Suppressor Proteins; D006005:Phosphorylases; D003402:Creatine Kinase; D018995:Myosin Heavy Chains