NEW IN THE USE OF BIOMARKERS IN ACUTE CORONARY SYNDROME
In the absence of ischemic changes on ECG should be assessed biomarkers to exclude myocardial infarction (MI), and further diagnostic testing to exclude ischemia in patients without MI. Although for the diagnosis of MI is routinely used by a number of biomarkers, only three of them – myoglobin, CPK-MB (CK-MB) and troponin – the most frequently used in cardiology practice. In addition, these markers are also used to identify patients at risk of recurrent cardiac events. Among the many new biomarkers in acute coronary syndrome, according to the results of individual studies, high expectations on lipoprotein associated phospholipase A2 – a marker of local inflammation in the plaques, high-sensitivity troponin, allowing in the first 2:00 to diagnose MI. Perspective may be a new marker of myocyte injury – cardiac protein that binds free fatty acids (H-FABP), matrix metalloproteinases-9, myeloperoxidase. However, despite the diversity of the constantly growing number of new biomarkers that reflect the molecular mechanisms of atherogenesis, from its initiation and ending of myocardial necrosis, to date only 3 of them – troponins, BNP and CRP, have found practical application in clinical cardiology, entered the international recommendations as diagnostic and prognostic markers in treating ACS. At the same time, only troponin is the only biomarkers used for diagnosis, prognosis and choice of tactics of treatment of patients with ACS.
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