title: Perspectives on the value of biomarkers in acute cardiac care and implications for strategic management.
abstract: Biomarkers in acute cardiac care are gaining increasing interest given their clinical benefits. This study is a review of the major conditions in acute cardiac care, with a focus on biomarkers for diagnostic and prognostic assessment. Through a PubMed search, 110 relevant articles were selected. The most commonly used cardiac biomarkers (cardiac troponin, natriuretic peptides, and C-reactive protein) are presented first, followed by a description of variable acute cardiac conditions with their relevant biomarkers. In addition to the conventional use of natriuretic peptides, cardiac troponin, and C-reactive protein, other biomarkers are outlined in variable critical conditions that may be related to acute cardiac illness. These include ST2 and chromogranin A in acute dyspnea and acute heart failure, matrix metalloproteinase in acute chest pain, heart-type fatty acid binding protein in acute coronary syndrome, CD40 ligand and interleukin-6 in acute myocardial infarction, blood ammonia and lactate in cardiac arrest, as well as tumor necrosis factor-alpha in atrial fibrillation. Endothelial dysfunction, oxidative stress and inflammation are involved in the physiopathology of most cardiac diseases, whether acute or chronic. In summary, natriuretic peptides, cardiac troponin, C-reactive protein are currently the most relevant biomarkers in acute cardiac care. Point-of-care testing and multi-markers use are essential for prompt diagnostic approach and tailored strategic management.
authors.affiliation: CCU Acute Cardiac Care Unit (CCU), Cardiology Division, University Hospital Notre Dame de Secours, St. Charbel Street, Byblos, Lebanon.
authors.forename: Antoine
authors.initials: A
authors.lastname: Kossaify
authors.forename: Annie
authors.initials: A
authors.lastname: Garcia
authors.forename: Sami
authors.initials: S
authors.lastname: Succar
authors.forename: Antoine
authors.initials: A
authors.lastname: Ibrahim
authors.forename: Nicolas
authors.initials: N
authors.lastname: Moussallem
authors.forename: Mikhael
authors.initials: M
authors.lastname: Kossaify
authors.forename: Gilles
authors.initials: G
authors.lastname: Grollier
keywords: acute cardiac care; assays; biomarker; management; point-of-care
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