Emerging Biomarkers in Acute Coronary Syndromes – A Pathophysiologic Perspective

Kluger, Nicola J; Legget, Malcolm E.

doi:10.1016/j.hlc.2022.01.015

Cited by 5 publications

(8 citation statements)

References 62 publications

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“…3). Each Tn complex interacted with the Tm molecule and both bind to seven actin monomers [15]. These proteins bind with tropomyosin to form a complex that functions as the backbone of striated muscle.…”

Section: Creatine Kinase (Ck)mentioning

confidence: 99%

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Interpreting Myocardial Enzymatic Biomarkers in the Setting of Acute Myocardial Infraction AMI

Kasar

Al-Bahrani

Mohsin

2022

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The rates of morbidity and mortality for acute myocardial infarction (AMI) have been rising quickly in the last few years. In the systemic circulatory loop, the heart normally pumps blood to the body's extremities. Cardiovascular disease, however, results from any heart function problem. The most fatal diseases in the world are known to be those involving the cardiovascular system. Over the past decade, biochemical marker testing are an important step in the diagnosis, and management of heart failure and in lowering one's risk of developing cardiovascular disease. Early diagnosis is paramount to choosing a clear and effective treatment strategy. Cardiac biomarkers are another effective method for classifying myocardial injury. The myocardial enzymatic biomarkers, also known as myocardial necrosis biomarkers, were among the various biomarkers that were initially studied. This review aims to allow for appropriate management steps to be initiated and more efficient and effective utilization of healthcare resources.

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Section: Creatine Kinase (Ck)mentioning

confidence: 99%

“…3. Cardiac troponins consist of three types of proteins: Troponin type I (TnI), Troponin type C (TnC), and type Troponin C (TnT)[15]…”

mentioning

confidence: 99%

Interpreting Myocardial Enzymatic Biomarkers in the Setting of Acute Myocardial Infraction AMI

Kasar

Al-Bahrani

Mohsin

2022

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“…Available circulating biomarkers of ACS, e.g., cardiac troponin, have transformed ACS management, prognostication, and resource allocation [ 5 ]. However, there is an ongoing search for additional biomarkers to provide valuable mechanistic insights, and further improve diagnostic and prognostic accuracy [ 6 , 7 ]. Ideally, such biomarkers should be rapidly measurable and easily interpretable using robust and reproducible analytical methods [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several proteins have been investigated as potential ACS biomarkers in view of their ability to reflect critical pathophysiological processes, e.g., atherosclerotic plaque instability, inflammation, myocardial cell injury, haemodynamic stress, and altered metabolism [ 6 , 7 ]. One such protein, albumin, has been shown to undergo chemical modifications, albeit the exact reactions remain elusive, during ischaemic states.…”

Section: Introductionmentioning

confidence: 99%

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Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Mangoni

Zinellu

2022

JCM

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The identification of novel circulating biomarkers of acute coronary syndrome (ACS) may improve diagnosis and management. We conducted a systematic review and meta-analysis of ischaemia-modified albumin (IMA), an emerging biomarker of ischaemia and oxidative stress, in ACS. We searched PubMed, Web of Science, and Scopus from inception to March 2022, and assessed the risk of bias and certainty of evidence with the Joanna Briggs Institute Critical Appraisal Checklist and GRADE, respectively. In 18 studies (1654 ACS patients and 1023 healthy controls), IMA concentrations were significantly higher in ACS (standard mean difference, SMD = 2.38, 95% CI 1.88 to 2.88; p < 0.001; low certainty of evidence). The effect size was not associated with pre-defined study or patient characteristics, barring the country where the study was conducted. There were no significant differences in effect size between acute myocardial infarction (MI) and unstable angina (UA), and between ST-elevation (STEMI) and non-ST-elevation MI (NSTEMI). However, the effect size was progressively larger in UA (SMD = 1.63), NSTEMI (SMD = 1.91), and STEMI (3.26). Our meta-analysis suggests that IMA might be useful to diagnose ACS. Further studies are warranted to compare the diagnostic performance of IMA vs. established markers, e.g., troponin, and to determine its potential utility in discriminating between UA, NSTEMI, and STEMI (PROSPERO registration number: CRD42021324603).

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Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort

Gürgöze

Akkerhuis

Oemrawsingh

et al. 2023

European Heart Journal: Acute Cardiovascular Care

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Aims Evidence regarding the role of serial measurements of biomarkers for risk assessment in post-acute coronary syndrome (ACS) patients is limited. The aim was to explore the prognostic value of four, serially measured biomarkers in a large, real-world cohort of post-ACS patients. Methods and results BIOMArCS is a prospective, multicentre, observational study in 844 post-ACS patients in whom 12,218 blood samples (median 17/patient) were obtained during one year follow-up. The longitudinal patterns of hs-cTnT, NT-proBNP, hs-CRP and GDF-15 were analysed in relation to the primary endpoint (PE) of CV mortality and recurrent ACS using multivariable joint models. Median age was 63 years, 78% were men and the PE was reached by 45 patients. The average biomarker levels were systematically higher in PE compared to PE-free patients. After adjustment for 6-months post-discharge GRACE score, 1 standard deviation increase in log[hs-cTnT] was associated with a 61% increased risk of the PE (hazard ratio[HR] 1.61, 95% confidence interval[CI] 1.02–2.44, P = 0.045) while for log[GDF-15] this was 81% (HR 1.81, 95% CI 1.28–2.70, P = 0.001). These associations remained significant after multivariable adjustment, while NT-proBNP and hs-CRP were not. Furthermore, GDF-15 level showed an increasing trend prior to the PE. (Structured Graphical Abstract) Conclusions Longitudinally measured hs-cTnT and GDF-15 concentrations provide prognostic value in the risk assessment of clinically stabilized patients post-ACS. Clinical Trial Registration The Netherlands Trial Register. Currently available at URL https://trialsearch.who.int/; Unique Identifiers: NTR1698 and NTR1106.

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Emerging Biomarkers in Acute Coronary Syndromes – A Pathophysiologic Perspective

Cited by 5 publications

References 62 publications

Interpreting Myocardial Enzymatic Biomarkers in the Setting of Acute Myocardial Infraction AMI

Interpreting Myocardial Enzymatic Biomarkers in the Setting of Acute Myocardial Infraction AMI

Serum Concentrations of Ischaemia-Modified Albumin in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort

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