Biomarkers of myocardial injury after cardiac arrest or myocardial ischemia.
Outcomes of victims of cardiac arrest or acute myocardial ischemic events have improved with advances in medical therapy. Heart failure, however, remains a leading cause of morbidity and mortality after these conditions have occurred. Clinical features may be useful for predicting patients who are at risk of developing such complications, but they lack of sensitivity and specificity. Biomarkers have been therefore suggested as means to provide relevant prognostic information. The more commonly used biomarkers after cardiovascular ischemic events, including cardiac arrest, are creatin kinases and troponins. In addition, natriuretic peptides and C-reactive protein have gained great interest and now sufficient data has been collected such to justify their clinical applicability. Finally, several other novel biomarkers, to be used after resuscitation from cardiac arrest or more generally after a myocardial ischemic event, have been anticipated. Nevertheless, the "perfect" biomarker, able to provide diagnosis and prognosis with high sensitivity and specificity does not exit. A multimarker strategy that categorizes patients based on the number of elevated biomarkers at presentation is therefore suggested.
Ristagno
Giuseppe
G
Weil Institute of Critical Care Medicine, 35100 Bob Hope DR, Rancho Mirage, California 92270, USA. gristag@gmail.com
Santonocito
Cristina
C
Li
Yongqin
Y
Li Volti
Giovanni
G
Gullo
Antonino
A
D053607:Adrenomedullin / Q000378:metabolism; D001127:Arginine Vasopressin / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D003402:Creatine Kinase / Q000378:metabolism; D019332:Endothelin-1 / Q000378:metabolism; D006323:Heart Arrest / Q000150:complications*; D006333:Heart Failure / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007113:Immunity, Innate / Q000502:physiology*; D017202:Myocardial Ischemia / Q000150:complications* / Q000276:immunology; D045265:Natriuretic Peptides / Q000378:metabolism; D000683:Serum Amyloid P-Component / Q000378:metabolism; D014336:Troponin / Q000378:metabolism; D000099153:Pentraxins
D053607:Adrenomedullin; D001127:Arginine Vasopressin; D015415:Biomarkers; D002097:C-Reactive Protein; D003402:Creatine Kinase; D019332:Endothelin-1; D045265:Natriuretic Peptides; D000683:Serum Amyloid P-Component; D014336:Troponin; D000099153:Pentraxins