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The additive value of biomarkers to clinical risk scores in acute coronary syndrome. Are biomarkers really ready for real world usage?
  1. Antonio Tello-Montoliu1,
  2. Francisco Marín2,
  3. Vanessa Roldán3,
  4. Gregory YH Lip4
  1. 1Department of Cardiology, Hospital Virgen de la Salud, Toledo, Spain
  2. 2Department of Cardiology, Hospital Virgen de la Arrixaca, Murcia, Spain
  3. 3Department of Hematology and Oncology, Hospital Morales Meseguer, Murcia, Spain
  4. 4University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, England UK
  1. Correspondence to Antonio Tello-Montoliu, Department of Cardiology, Hospital Virgen de la Salud, Adv/ Barber 35, Toledo, Spain; atellomont{at}hotmail.com

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To the editor: We read with great interest the study by Ang et al1, addressing the value of brain natriuretic peptide (BNP) levels in comparison with the GRACE score for acute coronary syndromes (ACS), and the additional predictive role of BNP on this established risk score.

The latter is of great interest to physicians managing ACS patients. Indeed, several new (and sometimes, not so new) biomarkers have been studied in relation to their prognostic role in ACS, and some give prognostic information in relation to new adverse events.2 Several biomarkers, like BNP or C-reactive protein (CRP), are currently available in the majority of hospitals and could be readily used in clinical practice. However, except for troponin, neither is currently being used for ACS risk stratification.

Do these new biomarkers really offer much …

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