Biochemical Markers of Myocardial Damage.
Heart diseases, especially coronary artery diseases (CAD), are the leading causes of morbidity and mortality in developed countries. Effective therapy is available to ensure patient survival and to prevent long term sequelae after an acute ischemic event caused by CAD, but appropriate therapy requires rapid and accurate diagnosis. Research into the pathology of CAD have demonstrated the usefulness of measuring concentrations of chemicals released from the injured cardiac muscle can aid the diagnosis of diseases caused by myocardial ischemia. Since the mid-1950s successively better biochemical markers have been described in research publications and applied for the clinical diagnosis of acute ischemic myocardial injury. Aspartate aminotransferase of the 1950s was replaced by other cytosolic enzymes such as lactate dehydrogenase, creatine kinase and their isoenzymes that exhibited better cardiac specificity. With the availability of immunoassays, other muscle proteins, that had no enzymatic activity, were also added to the diagnostic arsenal but their limited tissue specificity and sensitivity lead to suboptimal diagnostic performance. After the discovery that cardiac troponins I and T have the desired specificity, they have replaced the cytosolic enzymes in the role of diagnosing myocardial ischemia and infarction. The use of the troponins provided new knowledge that led to revision and redefinition of ischemic myocardial injury as well as the introduction of biochemicals for estimation of the probability of future ischemic myocardial events. These markers, known as cardiac risk markers, evolved from the diagnostic markers such as CK-MB or troponins, but markers of inflammation also belong to these groups of diagnostic chemicals. This review article presents a brief summary of the most significant developments in the field of biochemical markers of cardiac injury and summarizes the most recent significant recommendations regarding the use of the cardiac markers in clinical practice.
Department of Pathology, University of Colorado , Denver, USA.
Geza S
GS
Bodor
biochemical markers; cardiac markers; cardiac troponins; coronary artery disease; myocardial infarction
Clin Chem. 1999 Jul;45(7):1104-21
10388496
Clin Chem. 1992 Nov;38(11):2203-14
1424112
CRC Crit Rev Clin Lab Sci. 1978;9(4):273-302
401372
J Am Coll Cardiol. 2012 Oct 16;60(16):1581-98
22958960
Clin Chem. 1986 Apr;32(4):657-63
3955814
Science. 1954 Sep 24;120(3117):497-9
13195683
Clin Biochem. 2015 Mar;48(4-5):201-3
25204966
FASEB J. 1995 Jun;9(9):755-67
7601340
JAMA. 1981 Nov 6;246(18):2049-51
7288991
Cardiovasc Res. 1999 Apr;42(1):240-5
10435016
Clin Chem. 2003 Apr;49(4):537-9
12651803
JAMA. 2003 Jul 16;290(3):353-9
12865376
Int J Cardiol. 2004 Nov;97(2):297-301
15458698
Clin Chem. 1998 Sep;44(9):1919-24
9732977
J Am Coll Cardiol. 2000 Nov 15;36(6):1812-7
11092649
Clin Chem. 1997 Mar;43(3):476-84
9068591
Clin Chem. 1992 Dec;38(12):2396-400
1458574
Ann Clin Biochem. 2003 Mar;40(Pt 2):156-60
12662403
Clin Chem. 2009 Dec;55(12):2098-112
19815610
J Am Coll Cardiol. 2009 Sep 22;54(13):1165-72
19761938
Clin Chem. 2001 Mar;47(3):431-7
11238293
J Am Coll Cardiol. 2002 Sep 18;40(6):1044-50
12354426
Heart. 2016 Jan;102(2):120-6
26729608
Clin Chem. 1996 Dec;42(12):2039-41
8969648
Clin Chem. 2006 Sep;52(9):1685-92
16858078
J Am Coll Cardiol. 2000 Sep;36(3):959-69
10987628
Clin Chem. 1999 Dec;45(12):2129-35
10585344
Clin Chem. 1991 Aug;37(8):1405-11
1868602
Clin Chem Lab Med. 1999 Nov-Dec;37(11-12):1107-11
10726819
Ann Med Intern Fenn. 1965;54(3):129-36
5854023
Circulation. 2003 May 20;107(19):2403-5
12742986
Lancet. 2015 Dec 19;386(10012):2481-8
26454362
Clin Biochem. 1983 Feb;16(1):17-9
6345025
Circulation. 1998 Nov 3;98(18):1853-9
9799204
N Engl J Med. 1994 Mar 10;330(10):670-4
8054012
World J Cardiol. 2014 Apr 26;6(4):175-82
24772257
Circulation. 1998 Aug 25;98(8):731-3
9727541
Clin Chem. 1998 Jun;44(6 Pt 1):1198-208
9625043
J Mol Cell Cardiol. 1989 Dec;21(12):1349-53
2632816
Clin Chem. 1995 Dec;41(12 Pt 1):1710-5
7497610
J Neurol. 1989 Jul;236(5):284-7
2760646
Clin Cardiol. 2001 Mar;24(3 Suppl):I3-7
11286312
Am Heart J. 2016 Jan;171(1):92-102.e1-5
26699605
Ann Thorac Surg. 1971 May;11(5):431-7
5091151
Clin Chim Acta. 2011 Apr 11;412(9-10):748-54
21219893
Circulation. 2003 Sep 23;108(12):1440-5
12952835
Eur Heart J Acute Cardiovasc Care. 2016 Sep;5(5):399-406
26136512
JAMA. 2001 Nov 21;286(19):2405-12
11712935
Clin Chem. 2003 Aug;49(8):1331-6
12881449
Am J Cardiol. 1998 Sep 15;82(6):731-6
9761082
Scand J Clin Lab Invest. 1994 Jul;54(4):329-35
7939377
Circulation. 2007 Nov 27;116(22):2634-53
17951284
Clin Biochem. 2010 Aug;43(12):1034-6
20510894
Clin Chem. 2012 Jan;58(1):54-61
21965555
Am J Med. 2016 Mar;129(3):274-82.e2
26524709
J Am Coll Cardiol. 1998 Jun;31(7):1460-5
9626820