Perspectives on the Value of Biomarkers in Acute Cardiac Care and Implications for Strategic Management

Abstract

Biomarkers in acute cardiac care are gaining increasing interest given their clinical benefits. This study is a review of the major conditions in acute cardiac care, with a focus on biomarkers for diagnostic and prognostic assessment. Through a PubMed search, 110 relevant articles were selected. The most commonly used cardiac biomarkers (cardiac troponin, natriuretic peptides, and C-reactive protein) are presented first, followed by a description of variable acute cardiac conditions with their relevant biomarkers. In addition to the conventional use of natriuretic peptides, cardiac troponin, and C-reactive protein, other biomarkers are outlined in variable critical conditions that may be related to acute cardiac illness. These include ST2 and chromogranin A in acute dyspnea and acute heart failure, matrix metalloproteinase in acute chest pain, heart-type fatty acid binding protein in acute coronary syndrome, CD40 ligand and interleukin-6 in acute myocardial infarction, blood ammonia and lactate in cardiac arrest, as well as tumor necrosis factor-alpha in atrial fibrillation. Endothelial dysfunction, oxidative stress and inflammation are involved in the physiopathology of most cardiac diseases, whether acute or chronic. In summary, natriuretic peptides, cardiac troponin, C-reactive protein are currently the most relevant biomarkers in acute cardiac care. Point-of-care testing and multi-markers use are essential for prompt diagnostic approach and tailored strategic management.

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“…Several studies have demonstrated salivary biomarkers associated with AMI, as shown in Table 1 . By comparing these salivary biomarkers with those in plasma, as elaborated by Kossaify et al 27 , CRP, CK, CD40 ligand, cardiac troponin I, cardiac troponin T, some families of interleukin (IL), tumour necrosis factor alpha, matrix metalloproteinase (MMP), and myeloperoxidase share similarities with plasma biomarkers which also play significant roles in inflammation and plaque instability (Figure 2 ). Although these discoveries may enlighten the diagnostic utility of salivary proteomes as biomarkers in relation to CVD, none of the salivary biomarkers listed above have been verified to predict the onset of AMI.…”

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