NMWH
07-30-2010, 12:10 PM
Cardiac Biomarkers
What are they?i
Cardiac biomarkers are substances that are released into
the blood when the heart is damaged. Measurement of these
biomarkers is used to help diagnose, evaluate, and monitor
patients with suspected acute coronary syndrome (ACS).i
Only a few cardiac biomarker tests are routinely used by
physicians. The current biomarker test of choice for
detecting heart damage is troponin. Other cardiac
biomarkers are less specific for the heart and may be
elevated in skeletal muscle injury, liver disease, or kidney
disease. Many other potential cardiac biomarkers are being
researched, but their clinical utility has yet to be established.i
Note: Cardiac biomarkers are not the same tests as those
that are used to screen the general healthy population for
their risk of developing heart disease. Those can be found
under Cardiac Risk Assessment (http://www.mda-sy.com/vb/t1604.html).i
Laboratory Tests
Current cardiac biomarker tests used to help diagnose,
evaluate, and monitor patients suspected of having Acute
Coronary Syndrome (ACS):i
CK (http://www.mda-sy.com/vb/t1602.html) and (http://www.mda-sy.com/vb/t1602.html)CK-MB (http://www.mda-sy.com/vb/t1602.html)*
Troponin (http://www.mda-sy.com/vb/t1600.html) *
Myoglobin *
Additional biomarker tests that may be used to evaluate risk
of future cardiac events (prognosis):i
BNP or NT-proBNP: B-type natriuretic peptide; N-terminal *
pro b-type natriuretic peptide
hs-CRP : highly specific C-reactive protein *
Phased out biomarkers—the tests below are not specific for
damage to the heart and are no longer recommended for
evaluating patients with suspected ACS:i
AST: aspartate aminotransferase *
LDH: lactate dehydrogenase *
More general tests frequently ordered along with cardiac
biomarkers:i
Blood gases *
CMP: Comprehensive Metabolic Panel *
BMP: basic metabolic panel *
Electrolytes *
CBC: complete blood components *
On the horizon:i
Ischemia modified albumin (IMA) – This test has ---
received FDA approval for use with troponin and an
electrocardiogram. It is not widely available but may
become useful someday for identifying patients at
higher risk of heart attack.i
Non-laboratory Tests
These tests allow doctors to look at the size, shape, and
function of the heart as it is beating. They can be used to
detect changes to the rhythm of the heart as well as to
detect and evaluate damaged tissues and blocked arteries.i
EKG (ECG, electrocardiogram) (http://www.mda-sy.com/vb/t1603.html)i*
Nuclear scan *
Coronary angiography (or arteriography)i*
ECG (echocardiogram)i*
Stress testing *
Chest X-ray*
Common cardiac investigations (http://www.mda-sy.com/up//view.php?file=ce1470058d)
What are they?i
Cardiac biomarkers are substances that are released into
the blood when the heart is damaged. Measurement of these
biomarkers is used to help diagnose, evaluate, and monitor
patients with suspected acute coronary syndrome (ACS).i
Only a few cardiac biomarker tests are routinely used by
physicians. The current biomarker test of choice for
detecting heart damage is troponin. Other cardiac
biomarkers are less specific for the heart and may be
elevated in skeletal muscle injury, liver disease, or kidney
disease. Many other potential cardiac biomarkers are being
researched, but their clinical utility has yet to be established.i
Note: Cardiac biomarkers are not the same tests as those
that are used to screen the general healthy population for
their risk of developing heart disease. Those can be found
under Cardiac Risk Assessment (http://www.mda-sy.com/vb/t1604.html).i
Laboratory Tests
Current cardiac biomarker tests used to help diagnose,
evaluate, and monitor patients suspected of having Acute
Coronary Syndrome (ACS):i
CK (http://www.mda-sy.com/vb/t1602.html) and (http://www.mda-sy.com/vb/t1602.html)CK-MB (http://www.mda-sy.com/vb/t1602.html)*
Troponin (http://www.mda-sy.com/vb/t1600.html) *
Myoglobin *
Additional biomarker tests that may be used to evaluate risk
of future cardiac events (prognosis):i
BNP or NT-proBNP: B-type natriuretic peptide; N-terminal *
pro b-type natriuretic peptide
hs-CRP : highly specific C-reactive protein *
Phased out biomarkers—the tests below are not specific for
damage to the heart and are no longer recommended for
evaluating patients with suspected ACS:i
AST: aspartate aminotransferase *
LDH: lactate dehydrogenase *
More general tests frequently ordered along with cardiac
biomarkers:i
Blood gases *
CMP: Comprehensive Metabolic Panel *
BMP: basic metabolic panel *
Electrolytes *
CBC: complete blood components *
On the horizon:i
Ischemia modified albumin (IMA) – This test has ---
received FDA approval for use with troponin and an
electrocardiogram. It is not widely available but may
become useful someday for identifying patients at
higher risk of heart attack.i
Non-laboratory Tests
These tests allow doctors to look at the size, shape, and
function of the heart as it is beating. They can be used to
detect changes to the rhythm of the heart as well as to
detect and evaluate damaged tissues and blocked arteries.i
EKG (ECG, electrocardiogram) (http://www.mda-sy.com/vb/t1603.html)i*
Nuclear scan *
Coronary angiography (or arteriography)i*
ECG (echocardiogram)i*
Stress testing *
Chest X-ray*
Common cardiac investigations (http://www.mda-sy.com/up//view.php?file=ce1470058d)