RT Journal Article
SR Electronic
T1 Novel biochemical markers in suspected acute coronary syndrome: systematic review and critical appraisal
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1001
OP 1010
DO 10.1136/hrt.2009.189886
VO 96
IS 13
A1 Marieke S Dekker
A1 Arend Mosterd
A1 Arnoud W J van 't Hof
A1 Arno W Hoes
YR 2010
UL http://heart.bmj.com/content/96/13/1001.abstract
AB Context Early recognition of acute coronary syndrome (ACS) is essential. Cardiac troponins are not consistently elevated within the first hours after symptom onset.Objective Review current guidelines recommendations regarding biomarkers in the early assessment of ACS and review the evidence for using established and specific new diagnostic biomarkers.Data sources MEDLINE and EMBASE.Study selection Articles on diagnostic accuracy of ACS biomarkers.Data extraction Relevance of clinical domain, adequacy of measures of clinical utility and outcome assessment.Results The 73 articles identified on early biochemical markers CK-MB, myoglobin, heart-type fatty acid binding protein (H-FABP), ischemia modified albumin (IMA), pregnancy-associated plasma protein A, glycogen phosphorylase isoenzyme BB and myeloid-related protein 8/14 often did not quantify clinical utility correctly.Conclusions IMA and H-FABP seem to be promising biomarkers in the early assessment of ACS. There is an urgent need for adequately designed diagnostic studies of (novel) ACS markers against contemporary troponin assays.