الفهرس 
Cardiac biomarkersOnly 14 pages are availabe for public view
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Abstract
Cardiac markers are used in the diagnosis and risk stratification of patients with chest pain and suspected acute coronary syndrome (ACS).The cardiac troponins, in particular, have become the cardiac markers of choice for patients with ACS.
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.
Cardiac troponin is central to the definition of acute myocardial infarction (MI) in the consensus guidelines from the European Society of Cardiology (ESC) and the American College of Cardiology (ACC). However, an increased level of cTn is necessary, but not sufficient, for the diagnosis of AMI, that also requires clinical features of myocardial ischemia, indicated by symptoms of ischemia electrocardiographic changes indicative of new ischemia, development of pathological Q-waves, or imaging evidence of the new loss of viable myocardium or new regional wall motion abnormalities.
Increased cTn concentrations have been reported in cardiac, vascular,and respiratory disease and in association with infectious processes. In cases involving acute aortic dissection ,cerebrovascular accident ,treatment in an intensive care unit,and upper gastrointestinal bleeding, increased cTn predicts a longer time to diagnosis and treatment,increased length of hospital stay, and increased mortality. Also, cTn increase is diagnostically and prognostically useful in patients with cardiac inflammatory diseases and in patients with respiratory disease. In respiratory disease, cTn can help identify patients who would benefit from aggressive management.
In chronic renal failure patients the diagnostic sensitivity of cTn for ACS is decreased, but cTn is prognostic for the development of cardiovascular disease. cTn also provides useful information when increases are attributable to various iatrogenic causes and blunt chest trauma Information on the diagnostic and prognostic uses of cTn in conditions other than ACS and heart failure is accumulating.