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Intern Emerg Med. 2017 Mar;12(2):147-155. doi: 10.1007/s11739-017-1612-1. Epub 2017 Feb 11.

Cardiac biomarkers of acute coronary syndrome: from history to high-sensitivity cardiac troponin.

Author information

1
Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK.
2
Cardiology and Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield, S5 7AU, UK.
3
Department of Cardiovascular Science, University of Sheffield, Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
4
Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin Road, Bristol, BS28HW, UK.
5
Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland.
6
Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK. philip.haaf@usb.ch.
7
Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland. philip.haaf@usb.ch.

Abstract

The role of cardiac troponins as diagnostic biomarkers of myocardial injury in the context of acute coronary syndrome (ACS) is well established. Since the initial 1st-generation assays, 5th-generation high-sensitivity cardiac troponin (hs-cTn) assays have been developed, and are now widely used. However, its clinical adoption preceded guidelines and even best practice evidence. This review summarizes the history of cardiac biomarkers with particular emphasis on hs-cTn. We aim to provide insights into using hs-cTn as a quantitative marker of cardiomyocyte injury to help in the differential diagnosis of coronary versus non-coronary cardiac diseases. We also review the recent evidence and guidelines of using hs-cTn in suspected ACS.

KEYWORDS:

Acute coronary syndrome; Cardiac biomarkers; High-sensitivity cardiac troponin

PMID:
28188579
PMCID:
PMC5329082
DOI:
10.1007/s11739-017-1612-1
[Indexed for MEDLINE]
Free PMC Article

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