Markers to define ischemia: are they ready for prime time use in patients with acute coronary syndromes?
Optimal treatment of patients who present with chest pain is predicated on accurate identification of those patients with a cardiac etiology of their discomfort. Serial troponins and electrocardiograms are very sensitive for the detection of myocardial infarction but they are insensitive for the detection of ischemia. There are many analytes that are being actively evaluated for routine use to facilitate the identification of patients with myocardial ischemia. At present, only one assay is US Food and Drug Administration-approved for the exclusion of ischemia; many other analytes are under clinical evaluation and are briefly reviewed. At present, none of these analytes are yet appropriate for routine clinical use.
Adams
Jesse
J
University of Louisville, Division of Cardiology, 100 Mallard Creek, Suite 390, Louisville, KY 40202, USA. jadams03@bluegrass.net
D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D023201:CD40 Ligand / Q000502:physiology; D002794:Choline / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005979:Glutathione Peroxidase / Q000502:physiology; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis*; D045265:Natriuretic Peptides / Q000097:blood; D009195:Peroxidase / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D014336:Troponin / Q000502:physiology
D015415:Biomarkers; D005230:Fatty Acids, Nonesterified; D045265:Natriuretic Peptides; D014336:Troponin; D023201:CD40 Ligand; D002097:C-Reactive Protein; D009195:Peroxidase; D005979:Glutathione Peroxidase; D011266:Pregnancy-Associated Plasma Protein-A; D002794:Choline