Interv Akut Kardiol. 2013;12(1):28-33

Biochemical markers of myocardial necrosis in the current clinical practice

Tomáš Janota

3. interní klinika, Všeobecná fakultní nemocnice a 1. lékařská fakulta UK, Praha

Current laboratory diagonosis of myocardial necrosis due to myocardial infarction or any other cause is based primarily on examination

of myocardial troponins. Moreover, their plasma concentrations are now the cornerstone of myocardial infarction diagnosis. They

became earlier and earlier marker with increasing sensitivity. The negative predictive value is virtually 100%. However, elevated levels

of troponins are not exclusively caused by myocardial infarction. New problem is an interpretation of frequent mild elevations in healthy

or seemingly healthy persons. An effort to use routinely other early markers of myocardial necrosis has taken a back seat. The necessary

experience in use of troponins and some other cardiomarkers has been gained only in the last few years, during which they were

routinely used in clinical practice. This article summarises practical guidance on how to use the newer, as well as the older markers and

suggests how to interpret laboratory findings in relation to the Universal definition of myocradial infarction of 2012.

Keywords: biochemical markers of myocardial necrosis, acute myocardial infarction, acute coronary syndromes, early diagnosis

Published: February 21, 2013  Show citation