Bench-to-bedside review: the value of cardiac biomarkers in the intensive care patient.
The use of cardiac biomarkers in the intensive care setting is gaining increasing popularity. There are several reasons for this increase: there is now the facility for point-of-care biomarker measurement providing a rapid diagnosis; biomarkers can be used as prognostic tools; biomarkers can be used to guide therapy; and, compared with other methods such as echocardiography, the assays are easier and much more affordable. Two important characteristics of the ideal biomarker are disease specificity and a linear relationship between the serum concentration and disease severity. These characteristics are not present, however, in the majority of biomarkers for cardiac dysfunction currently available. Those clinically useful cardiac biomarkers, which naturally received the most attention, such as troponins and B-type natriuretic peptide, are not as specific as was originally thought. In the intensive care setting, it is important for the user to understand the degree of specificity of these biomarkers and that the interpretation of the results should always be guided by other clinical information. The present review summarizes the available biomarkers for different cardiac conditions. Potential biomarkers under evaluation are also briefly discussed.
McLean
Anthony S
AS
Department of Intensive Care Medicine, Nepean Hospital, University of Sydney, Sydney, NSW 2750, Australia. mcleana@med.usyd.edu.au
Huang
Stephen J
SJ
Salter
Mark
M
D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D023201:CD40 Ligand / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis*; D002794:Choline / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D006801:Humans; D007362:Intensive Care Units; D007378:Interleukins / Q000097:blood; D009206:Myocardium / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009336:Necrosis; D009195:Peroxidase / Q000097:blood; D019095:Point-of-Care Systems; D018805:Sepsis / Q000175:diagnosis; D012709:Serum Albumin / Q000032:analysis; D014336:Troponin / Q000097:blood; D054832:Urocortins / Q000097:blood
D015415:Biomarkers; D018394:CA-125 Antigen; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D007378:Interleukins; D012709:Serum Albumin; D014336:Troponin; D054832:Urocortins; D020097:Natriuretic Peptide, Brain; D023201:CD40 Ligand; D009195:Peroxidase; D052279:Creatine Kinase, MB Form; D002794:Choline