The Biomarkers for Acute Myocardial Infarction and Heart Failure

Abstract

The use of a large number of cardiovascular biomarkers, meant to complement the use of the electrocardiogram, echocardiography cardiac imaging, and clinical symptom assessment, has become a routine in clinical diagnosis, differential diagnosis, risk stratification, and prognosis and guides the management of patients with suspected cardiovascular diseases. There is a broad consensus that cardiac troponin and natriuretic peptides are the preferred biomarkers in clinical practice for the diagnosis of the acute coronary syndrome and heart failure, respectively, while the roles and possible clinical applications of several other potential biomarkers are still under study. This review mainly focuses on the recent studies of the roles and clinical applications of troponin and natriuretic peptides, which seem to be the best-validated markers in distinguishing and predicting the future cardiac events of patients with suspected cardiovascular diseases. Additionally, the review briefly discusses some of the large number of potential markers that may play a more prominent role in the future.

Cardiac Injury Biomarkers and the Risk of Death in Patients with COVID-19: A Systematic Review and Meta-Analysis

“…Peer-reviewed and preprint articles were included. Definitive myocardial injury biomarkers included cTnI, cTnT, and NT-proBNP [ 12 ], and their elevated values in the serum (above the 99th percentile upper reference limit) have indicated cardiac injury. In addition to baseline values, dynamic laboratory findings of the definitive biomarkers during hospitalization in survived and nonsurvived groups were investigated.…”

“…In addition to baseline values, dynamic laboratory findings of the definitive biomarkers during hospitalization in survived and nonsurvived groups were investigated. Moreover, baseline creatine kinase-myocardial bound (CK-MB), myoglobin, and the inflammatory parameters interleukin-6 (IL-6) and C-reactive protein (CRP) were considered as secondary biomarkers [ 12 ]. Studies recruiting specific populations of patients, such as critically ill and elderly, were excluded to optimize the generalizability of the results and to exclude the effects of aberrant cardiovascular biomarkers in such populations on the primary outcomes (mortality or survival).…”

SARS-CoV-2 and the cardiovascular system

“…Indeed, 16% of patients with underlying CVD but with normal TnT levels had a relatively favorable outcome [42] . Available data on the role of cardiac biomarkers, supported the role of assessing TnT and natriuretic peptides (NT-proBNP and BNP) for cardiac risk stratification and prognostication of patients with severe COVID-19 [47] , Based on the evidence of myocardial injury and the presence of CV complications, this might improve CV care among COVID-19 patients, as well as decrease the risk of infection, but there could be some limitations [48] . Nevertheless, additional novel biomarkers are needed for CV disease diagnosis, risk stratification, and management in COVID-19…”

Advances in the Development of Biomarkers for Poststroke Epilepsy

“…Recent studies suggest that inflammatory mediators, such as interleukin-(IL-) 1β, IL-6, and IL-10, play a significant role in the underlying pathophysiology of epilepsy, contributing to the onset and perpetuation of seizures [21,22]. Interleukin-6 (IL-6), regarded as the upstream mediator of the inflammatory reaction [23], is rapidly upregulated after acute CNS injury. The determination of the IL-6 level is a good predictor of poststroke epilepsy.…”