Diagnostic efficiency of Serum Cardiac biomarkers of myocardial ischemia and acute myocardial infarction

Abstract

Serum glutamate oxaloacetate transaminase (SGOT) was the first newlineserum marker that was employed as clinical diagnostic tool in 1950s to newlineidentify MI. In the later part of the 20th century, highly sensitive and specific newlineassays for the detection of myocardial damage, such as CK, CPK-MB, newlinetroponins and high sensitive cardiac troponins and myoglobin have emerged. newlineCirculating concentrations of B-type natriuretic peptide (BNP) and the newlineN-terminal fragment of its pro hormone (NT-proBNP), ischemia modified newlinealbumin (IMA) and heart fatty acid binding protein (H-FABP) are emerging as newlineclinically useful tools for the diagnosis of CAD. However, still research is newlineprogressing to employ these as diagnostic markers for AMI. Hence there is a newlinerequirement of comparing these newer and emerging parameters along with newlineconventional serum markers for their diagnostic ability, sensitivity and newlinespecificity in ischemia and infarction of heart. Apart from this, there is a need newlineto study the pattern progressive change of these markers in ischemia and newlineinfarction. During myocardial ischemia or infarction, there will be an elevation newlinein the serum biomarkers that are released in a detectable range due to newlinecardiac myocyte damage. However, the elevation may not be similar at newlinedifferent time periods for each marker as the release kinetics are different. newlineThe markers of ischemia and infarction may exhibit different patterns and newlinehowever, much data is unavailable. Studies have reported that to obtain the newlinebest diagnostic result, the analysis should be carried out at six to nine hours newlineafter the onset of chest pain. In unspecified onset, the analysis should be newlinecarried out at the time of admission and at six to nine hours and at twelve to twenty four hours (Jaffe et al, 2000). newlineSeveral biomarkers are introduced that are specific and sensitive for newlinedifferent stages of cardiac ailments. Research is also continuing with newlinemolecular markers at the genetic levels.