Table 1

Summary of biomarkers in acute myocardial infarction

BiomarkersDiagnostic valuePrognostic value
Myocardial necrosisAST1–3 First biomarker of AMI but lacks specificityNo data
CK/CK-MB4 Not as sensitive or specific as cTnNot consistently predictive of adverse events
Troponin5–19 Highly sensitive and specific, current ‘gold standard’ for AMI diagnosisIndependent predictor of adverse events
Myoglobin
20–24
Sensitive early after symptom onset, negative predictive value, but lacks specificityPredictive of mortality in renal insufficiency
IMA25 26 Less sensitive than cTn and lacks specificityPossibly predictive of adverse events
hFABP27–32 Sensitive early after symptom onset, but lacks specificityPredictive of mortality
NeuroendocrineBNP/NT-proBNP33–40 Not sensitive or specificHighly predictive of heart failure and mortality
Adrenomedullin
41 42
Possibly predictive of adverse events
RASS43
InflammationCRP47–54 Not sensitive or specific. The diagnostic accuracy of cTn can be increased when combining with some of these inflammatory biomarkersPossibly predictive of heart failure and mortality
IL-655–57
TNF-α58
PCT59–61
MPO62–64
MMP65 66
sCD40L67
PGF68
Other novel cardiac biomarkersmiRNAs69–78 Raised but not sensitive or specific for AMIPossibly predictive of mortality and heart failure
ST279–81 Raised but not sensitive or specific for AMIPredictive of mortality and heart failure
GDF-1582–84 Raised but not sensitive or specific for AMIPredictive of mortality and ischaemia
Gal-385–89 Raised in AMI but insufficient dataPossibly predictive of adverse events
  • AMI, acute myocardial infarction; cTn, cardiac troponin; IMA, ischaemia-modified albumin.