Electroanalytical point-of-care detection of gold standard and emerging cardiac biomarkers for stratification and monitoring in intensive care medicine - a review

Abstract

Determination of specific cardiac biomarkers (CBs) during the diagnosis and management of adverse cardiovascular events such as acute myocardial infarction (AMI) has become commonplace in emergency department (ED), cardiology and many other ward settings. Cardiac troponins (cTnT and cTnI) and natriuretic peptides (BNP and NT-pro-BNP) are the preferred biomarkers in clinical practice for the diagnostic workup of AMI, acute coronary syndrome (ACS) and other types of myocardial ischaemia and heart failure (HF), while the roles and possible clinical applications of several other potential biomarkers continue to be evaluated and are the subject of several comprehensive reviews. The requirement for rapid, repeated testing of a small number of CBs in ED and cardiology patients has led to the development of point-of-care (PoC) technology to circumvent the need for remote and lengthy testing procedures in the hospital pathology laboratories. Electroanalytical sensing platforms have the potential to meet these requirements. This review aims firstly to reflect on the potential benefits of rapid CB testing in critically ill patients, a very distinct cohort of patients with deranged baseline levels of CBs. We summarise their source and clinical relevance and are the first to report the required analytical ranges for such technology to be of value in this patient cohort. Secondly, we review the current electrochemical approaches, including its sub-variants such as photoelectrochemical and electrochemiluminescence, for the determination of important CBs highlighting the various strategies used, namely the use of micro- and nanomaterials, to maximise the sensitivities and selectivities of such approaches. Finally, we consider the challenges that must be overcome to allow for the commercialisation of this technology and transition into intensive care medicine. Graphical abstract

Cardiac Biomarkers in 2022 – a Vital Tool for Emergency Care

“…The method used for the determination of cardiac troponin may be variable, and several new-generation equip-ment have been introduced in the last years for the determination of hs-cTn T or I. 15,16 The analytical agreement between the two types of Tn (I and T) seems to be high, one study reporting an agreement coefficient of 95.2%. 17 In a study on 5,377 patients presenting to the ED with chest pain and suspected ACS, the implementation of hs-cTnT determination increased the rates of direct discharge from the ED, without any increase in mortality.…”

Electroanalysis overview: additive manufactured biosensors using fused filament fabrication

“…The eld of electrochemical biosensors is diverse, tackling environmental monitoring, medical diagnosis, athletic performance tracking via wearable biosensors and food and drink safety. [12][13][14][15][16][17][18][19][20][21][22][23][24] The design and fabrication of electrochemical biosensors involves customization of sensor substrates, selection, and integration of a biorecognition element specic to the target analyte along with a transduction platform to detect the biorecognition event and convert it to a recordable form. It is this requirement for a conductive transduction platform which leads to FFF and electrochemistry synergising so well, coined additive manufacturing electrochemistry.…”

Optical Nanobiosensor-Based Point-of-Care Testing for Cardiovascular Disease Biomarkers

“…Recently, biosensors were widely used as a powerful analytical tool for the detection of specific targeted cardiac biomarkers, which includes interaction between antigen and antibody, aptamer, and protein detection. − Hence, the rapid detection of cardiac biomarker is required for the early detection of CVDs, and it also helps to start immediate medical treatment. Currently, researchers have devoted themselves to developing nanomaterials-based biosensor probes for rapid detection, easy access, and low-cost cardiac biomarker analysis, which can be performed in both laboratory and point-of-care (POC) sensing systems. − Nanomaterials have attracted great attention due to their unique physical and chemical properties, which include a larger surface area with excellent biocompatibility when immobilized with biorecognition probes and also specific photocatalytic activity . The development of nanobiosensor probes has used different types of nanomaterials such as silver, , gold, , quantum dots, , mesoporous silica nanoparticles, , magnetic nanoparticles, , and carbon nanomaterials (carbon dots, graphene, and carbon nanotubes). , Those types of nanomaterials have been utilized for optical or electrochemical signal generation, transduction, and amplification.…”