Abstract
New biomarkers of myocardial ischemia have the potential to improve diagnostic accuracy of acute coronary syndrome (ACS) within a shorter time interval after symptom onset. This paper reviews the avaiable information and evaluates the evidence for use of new biomarkers in diagnosing ACS in patients presenting with chest pain or symptoms suggestive of cardiac ischemia to the emergency department or chest pain unit.
Ischemia modified albumin, measured using the albumin cobalt binding test, is currently the most promising biomarker for early detection of ischemia before the onset of irreversible cardiac injury. Fatty acid bindig protein, B-type natriuretic peptide, copeptin, and matrix metalloproteinase-9 are other promising biomarkers.
According this progress, we have to conclude, that there is inadequate evidence suggesting the routine testing of these markers in isolation, however these biomarkers have the potintial to improve the sensitivity of diagnosing ACS when combined with cardiac-specific troponin.