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 Printable version |
The new biological markers in the assessment of acute coronary syndromes |
Sang Thrombose Vaisseaux. Volume 16, Number 6, 289-94, Juin 2004, Mini-revue
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 Résumé
Article gratuit
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Author(s) : Pierre-Yves Lévy |
Summary : Biological markers play a leading role in the diagnosis and management of acute coronary syndromes. Each stage of coronary disease may now be assessed by a biological marker\; the C-reactive protein (CRP) as a marker of inflammation\; ischaemia-modified albumin (IMA) as a marker of ischaemia\; creatinine kinase MB and troponins as markers of necrosis\; B-natiuretic peptide (BNP) and N-proBNP as markers of neurohormonal activation. High sensitivity C-reactive protein is useful in the prediction of a first cardiovascular event. The IMA is a very sensitive test which becomes positive before the onset of necrosis. Creatinine kinase MB remains useful for the diagnosis of early recurrence of necrosis and for assessing infarct size. Although not specific, myoglobin is the most sensitive marker for the early diagnosis of necrosis (<\; 6 hours). Even a small increase in troponin is associated with a high risk of coronary disease which explains the use of this marker for the selection of patients requiring early and aggressive management. In acute coronary syndromes, increased BNP is associated with a high risk of mortality and of cardiac failure. These markers investigate differents stages of acute coronary syndromes and have independent prognostic significance when requested together. The simultaneous prescription of marker measurements should help determine the risk of coronary syndromes and direct appropriate management. |
Keywords : acute coronary syndrome, cardiac troponins, B-type natriuretic peptide, ischemia modified albumin |
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