n CME : Your SA Journal of CPD - Biochemical markers in cardiac disease : main article

Volume 24, Issue 7
  • ISSN : 0256-2170



Cardiovascular disease represents a continuum from UA to AMI. This has required a redefinition of clinical criteria for myocardial infarction. <BR>Cardiac troponins play a pivotal role in the diagnosis of AMI and the risk stratification of ACS patients. <BR>Elevated troponin levels may identify patients without ECG changes / CK-MB elevation to be at risk for significant cardiac events. <BR>Serial sampling is important for accurate diagnosis. &lt;BR&gt; 'Cardiac enzymes' (CK, AST, LDH) are obsolete. <BR>Other causes of cardiac pathology should be considered where troponin levels are elevated in the absence of clinical ischaemia. <BR>The increased role of cardiac markers in the diagnosis of AMI / ACS requires reliable biomarkers with rapid turnaround time. Clinically and analytically appropriate cut-off values must be used. <BR>Biomarker studies should not delay appropriate intervention in overt AMI. <BR>The advent of markers for myocardial ischaemia will facilitate earlier exclusion of AMI. <BR>There is an evolving role for the laboratory in the evaluation of cardiac disease, particularly in the areas of cardiac dysfunction (BNP, pro-BNP) and general biochemical or genetic risk factors.

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