RESUMEN
The diagnosis and management of patients with acute coronary syndrome (ACS) have evolved dramatically over the past decade. Biomarkers play an important role in the diagnosis of ACS, especially in unstable angina and non-ST-segment elevation myocardial infarction. Among these, cardiac troponin and creatine kinase appear to be the most sensitive and specific markers of myocardial injury. Recent studies have revealed several novel biomarkers. Elevated levels of C-reactive protein and interleukin-6 are strong independent markers of increased mortality among patients with ACS. However, the ideal biomarkers that offer early detection, risk stratification, selection of therapy, monitoring disease progression, and treatment efficacy remain to be elucidated. This review assesses limitations and contemporary needs for biomarkers in the context of diagnosis of ACS. It also discusses the newly developing technologies for novel biomarkers or novel biomarker protein signatures discovery, and importance of point-of-care testing for future management.
Asunto(s)
Humanos , Síndrome Coronario Agudo , Sangre , Patología , Biomarcadores , Sangre , Creatina Quinasa , Sangre , Electrocardiografía , Mioglobina , Sangre , Necrosis , Sangre , Estrés Oxidativo , Activación Plaquetaria , Troponina I , Sangre , Troponina T , SangreRESUMEN
<p><b>INTRODUCTION</b>Coronary artery disease (CAD) is the leading cause of death following ischaemic stroke. We aimed to study the prevalence and associations of concomitant CAD among ischaemic stroke patients in Singapore.</p><p><b>MATERIALS AND METHODS</b>We prospectively studied 2686 consecutive Asian ischaemic stroke patients.</p><p><b>RESULTS</b>CAD was prevalent among 24% of the study patients. Older age, hypertension, diabetes, hyperlipidaemia, atrial fibrillation, large stroke and South Asian ethnicity were independently associated with CAD.</p><p><b>CONCLUSIONS</b>The variables found to be associated with CAD are known atherosclerotic risk factors (older age, hypertension, diabetes, hyperlipidaemia) or associations of cardioembolic stroke (atrial fibrillation, large stroke). The over-representation of South Asians with concomitant CAD is consistent with the high burden of CAD in this ethnic group.</p>