Summary of biomarkers in acute myocardial infarction
Biomarkers | Diagnostic value | Prognostic value | |
Myocardial necrosis | AST1–3 | First biomarker of AMI but lacks specificity | No data |
CK/CK-MB4 | Not as sensitive or specific as cTn | Not consistently predictive of adverse events | |
Troponin5–19 | Highly sensitive and specific, current ‘gold standard’ for AMI diagnosis | Independent predictor of adverse events | |
Myoglobin 20–24 | Sensitive early after symptom onset, negative predictive value, but lacks specificity | Predictive of mortality in renal insufficiency | |
IMA25 26 | Less sensitive than cTn and lacks specificity | Possibly predictive of adverse events | |
hFABP27–32 | Sensitive early after symptom onset, but lacks specificity | Predictive of mortality | |
Neuroendocrine | BNP/NT-proBNP33–40 | Not sensitive or specific | Highly predictive of heart failure and mortality |
Adrenomedullin 41 42 | Possibly predictive of adverse events | ||
RASS43 | |||
Inflammation | CRP47–54 | Not sensitive or specific. The diagnostic accuracy of cTn can be increased when combining with some of these inflammatory biomarkers | Possibly predictive of heart failure and mortality |
IL-655–57 | |||
TNF-α58 | |||
PCT59–61 | |||
MPO62–64 | |||
MMP65 66 | |||
sCD40L67 | |||
PGF68 | |||
Other novel cardiac biomarkers | miRNAs69–78 | Raised but not sensitive or specific for AMI | Possibly predictive of mortality and heart failure |
ST279–81 | Raised but not sensitive or specific for AMI | Predictive of mortality and heart failure | |
GDF-1582–84 | Raised but not sensitive or specific for AMI | Predictive of mortality and ischaemia | |
Gal-385–89 | Raised in AMI but insufficient data | Possibly predictive of adverse events |
AMI, acute myocardial infarction; cTn, cardiac troponin; IMA, ischaemia-modified albumin.