Mini Review - (2023) Volume 7, Issue 2
Received: 01-Apr-2023, Manuscript No. jchd-23-101796;
Editor assigned: 03-Apr-2023, Pre QC No. P-101796;
Reviewed: 15-Apr-2023, QC No. Q-101796;
Revised: 21-Apr-2023, Manuscript No. R-101796;
Published:
29-Apr-2023
, DOI: 10.37421/2684-6020.2023.7.174
Citation: Schmidt, Erica. “The Impact of Novel Biomarkers in
Early Detection and Diagnosis of Myocardial Infarction.” J Coron Heart Dis 7
(2023): 174.
Copyright: © 2023 Schmidt E. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Myocardial infarction, commonly known as a heart attack, is a leading cause of morbidity and mortality worldwide. Early detection and prompt diagnosis play a crucial role in the effective management of myocardial infarction, as it enables timely intervention and improves patient outcomes. Traditional biomarkers, such as troponins and creatine kinase, have been widely used for diagnosing myocardial infarction. However, the quest for more sensitive and specific biomarkers has led to the discovery of novel biomarkers that can provide valuable insights into the pathophysiology and early detection of myocardial infarction. This research article aims to review and discuss the impact of these novel biomarkers in the early detection and diagnosis of myocardial infarction, highlighting their potential clinical applications and future directions.
Myocardial infarction • Novel biomarkers • Regulatory proteins
Myocardial Infarction (MI), commonly known as a heart attack, is a lifethreatening condition caused by the interruption of blood flow to the heart muscle. Timely detection and accurate diagnosis of MI are critical for initiating prompt treatment and improving patient outcomes. Traditional biomarkers, such as troponins and creatine kinase, have been widely used for diagnosing MI. However, they have certain limitations, including delayed release and lack of specificity, which can hinder early detection and diagnosis. To overcome these limitations, researchers have been actively exploring and identifying novel biomarkers that can provide greater sensitivity and specificity in the early detection and diagnosis of MI [1-3].
These novel biomarkers offer the potential to revolutionize the field of cardiovascular medicine by enabling more precise risk stratification, earlier intervention, and improved patient care. The impact of these novel biomarkers lies in their ability to detect myocardial injury at an earlier stage, even before the onset of symptoms or changes in traditional biomarkers. By capturing the subtle biochemical changes associated with myocardial damage, these biomarkers can aid in identifying patients who are at a high risk of MI or who are experiencing a silent MI. Moreover, they can help differentiate different types of MI, such as STSegment Elevation MI (STEMI) and Non-ST-Segment Elevation MI (NSTEMI), which require different treatment approaches.
Traditional biomarkers in myocardial infarction
The diagnosis of myocardial infarction (MI) has traditionally relied on the measurement of specific biomarkers released into the bloodstream following cardiac injury. These biomarkers play a crucial role in the identification and confirmation of myocardial damage, guiding clinical decision-making and determining appropriate treatment strategies. The two most widely used traditional biomarkers for MI are troponins and Creatine Kinase (CK).
Troponins
Troponins are regulatory proteins found in cardiac muscle cells. Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are the isoforms specific to the myocardium. Troponins are highly sensitive and specific biomarkers for MI and have become the gold standard for diagnosing myocardial injury [4,5].
Troponin levels rise within hours of myocardial injury, peaking at approximately 24 to 48 hours and remaining elevated for several days. The high sensitivity and specificity of troponins allow for the detection of even minor myocardial damage, including silent MIs. Serial measurements of troponin levels are often necessary to confirm the diagnosis and assess the extent of myocardial injury.
Creatine Kinase (Ck)
Creatine kinase, specifically the myocardial isoform CK-MB, has been used as a biomarker for MI. CK-MB is released into the bloodstream following myocardial injury, and its levels increase within 4 to 6 hours of symptom onset, peaking at around 12 to 24 hours. However, CK-MB lacks the sensitivity and specificity of troponins and has been largely replaced by troponin measurements in clinical practice.
Other biomarkers, such as total CK and CK-MB relative index (CK-MB/ total CK ratio), have been used historically but are less specific to myocardial injury. These biomarkers may be influenced by extracardiac factors, limiting their diagnostic accuracy.
Although troponins and CK-MB have been valuable in the diagnosis of MI, they have certain limitations. Troponin release may be delayed in some cases, particularly in non-ST-segment elevation MI (NSTEMI), which can delay the diagnosis and potentially impact treatment decisions. Additionally, troponins can remain elevated for an extended period, making it challenging to differentiate acute from chronic myocardial injury. Moreover, troponin elevations can occur in conditions other than MI, such as myocarditis, congestive heart failure, renal failure, and pulmonary embolism, leading to false-positive results. These limitations highlight the need for more sensitive and specific biomarkers to enhance the early detection and accurate diagnosis of MI.
Clinical applications
Early detection and accurate diagnosis of myocardial infarction (MI) are of paramount importance for initiating prompt treatment, reducing myocardial damage, and improving patient outcomes. The advancements in biomarker research and diagnostic techniques have paved the way for various clinical applications that can significantly impact the management of MI.
Risk Stratification
Early detection of MI allows for risk stratification of patients, enabling healthcare professionals to identify individuals at higher risk of adverse cardiac events. Biomarkers, such as high-sensitivity troponins and novel biomarkers, provide valuable information regarding the severity and extent of myocardial injury, aiding in risk assessment and prognostication. High levels of biomarkers indicate a larger myocardial infarct size and a higher likelihood of complications, helping clinicians allocate appropriate resources and interventions to high-risk patients [6].
Prognosis assessment
Accurate diagnosis and early intervention also contribute to assessing the prognosis of patients with MI. Biomarkers can serve as indicators of longterm outcomes, including mortality and the risk of future cardiovascular events. Patients with elevated levels of troponins or other biomarkers may require more aggressive treatments, intensive monitoring, and follow-up care to minimize the risk of adverse outcomes. Longitudinal measurements of biomarkers over time can provide insights into disease progression, response to treatment, and the need for additional interventions.
Tailoring treatment strategies
Early detection and diagnosis of MI enable healthcare providers to tailor treatment strategies based on the specific type and severity of myocardial injury. Biomarkers help differentiate between ST-Segment Elevation MI (STEMI) and Non-ST-Segment Elevation MI (NSTEMI), guiding the choice of reperfusion therapies such as percutaneous coronary intervention (PCI) or thrombolytic therapy. Moreover, biomarkers aid in identifying patients who may benefit from additional therapies, such as antithrombotic agents, lipid-lowering drugs, and beta-blockers, to reduce the risk of recurrent events and improve long-term outcomes.
The early detection and accurate diagnosis of myocardial infarction are critical for timely intervention and improved patient outcomes. Novel biomarkers have the potential to overcome the limitations of traditional biomarkers and offer valuable insights into the pathophysiology and early stages of myocardial infarction. Further research and validation studies are required to establish the clinical utility and standardize the use of these biomarkers in routine practice.
None.
Authors declare no conflict of interest.
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Journal of Coronary Heart Diseases received 15 citations as per Google Scholar report
