Nuevos marcadores en el síndrome coronario agudo
- David Pérez Surribas
- María Cruz Cárdenas Fernández
- Mariano Cortés Rius
- María Fernández García
- Miguel García Montes
- María Isabel Llompart Alabern
- Teresa Rodríguez González
- Carmen Valldecabres Ortiz
- José Antonio Viedma Contreras
- Edgar Zapico Muñiz
- Cecilia Martínez Brú
ISSN: 1888-4008
Datum der Publikation: 2009
Ausgabe: 2
Nummer: 1
Seiten: 34-46
Art: Artikel
Andere Publikationen in: Revista del laboratorio clínico
Zusammenfassung
Myocardical ischemia involves 1.3% of the patients attending emergency departments in Spain. The management of these patients is complex, due to the risk of an incorrect discharge diagnosis, the benefit of rapid revascularization and the excessive cost due to unnecessary admissions. There has been a significant improvement in the development of new cardiac biomarkers over the last ten years. Biomarkers traditionally used for identifying acute coronary syndrome were indicators of myocardial necrosis. This role has currently been expanded. There are still some limitations in the measurement of these biomarkers, due to lack of standardised assays or certified calibrators. Ischemia-modified albumin in conjunction with cardiac troponin and electrocardiogram, can help to rule out an acute coronary syndrome in patients with a low probability of having myocardical ischemia. Heart-type fatty acid-binding protein is a strong necrosis biomarker in the early diagnosis of acute myocardical infarction. C-reactive protein, natriuretic peptides and myeloperoxidase have been shown to complement cardiac troponin in the prognosis of acute coronary syndrome. Soluble CD40 ligand enables the identification of a subgroup of patients who will benefit from a treatment in acute coronary syndrome. There is currently not enough evidence to replace new biomarkers with any of these already been recommended by the scientific societies. Also, the assays of some of them are not sufficiently rapid. A multimarker strategy must be created to take into account the existing scientific-based evidence, with the aim of improving outcomes in patients.