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Potential value for new diagnostic markers in the early recognition of acute coronary syndromes

Published online by Cambridge University Press:  21 May 2015

Giuseppe Lippi ,
Martina Montagnana ,
Gian Luca Salvagno  and
Gian Cesare Guidi
Giuseppe Lippi*
Affiliation:
Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Universitá degli Studi di Verona, Verona, Italy
Martina Montagnana
Affiliation:
Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Universitá degli Studi di Verona, Verona, Italy
Gian Luca Salvagno
Affiliation:
Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Universitá degli Studi di Verona, Verona, Italy
Gian Cesare Guidi
Affiliation:
Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Universitá degli Studi di Verona, Verona, Italy
*
Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Universitá degli Studi di Verona, Ospedale Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134 - Verona, Italy; tel 0093-045-8074516, fax 0039-045-8201889, ulippi@tin.it

Abstract

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The diagnostic approach to acute coronary syndromes (ACS) remains one of the most difficult and controversial challenges facing emergency physicians. In recent years, cardiac troponins have emerged as the biochemical “gold standard” for diagnosis of patients with acute chest pain, enhancing our ability to recognize ACS. Early diagnosis and treatment of myocardial ischemia improve patient outcomes, but conventional markers are often nondiagnostic at the time of arrival at the emergency department. Promising new biomarkers, which appear earlier after the onset of ischemia, are being studied and integrated into clinical practice. Some are markers of myocyte necrosis, but others, including ischemia-modified albumin and natriuretic peptides, detect myocardial ischemia and myocardial dysfunction. The aim of the present article is to review the diagnostic approach to ACS, focusing on recent literature describing novel biochemical markers. If ongoing and future studies confirm their role in probability-based models risk assessment, a new era in the diagnostic approach to ACS may be dawning.

Keywords

acute coronary syndromesacute myocardial infarctionischemia modified albuminlaboratory biomarkersmyocardial ischemiabrain natriuretic peptide
Type
Education • Éducation
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 1 , January 2006 , pp. 27 - 31
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

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