Emerging cardiac markers in coronary disease: role of brain natriuretic peptide and other biomarkers.

Brain natriuretic peptides (BNP and pro-BNP) represent useful biomarkers in heart failure diagnosis and risk stratification; more recently their clinical use has been applied to acute coronary syndrome with and without ST segment elevation. Few studies have demonstrated that hormone dosage can add clinical and prognostic information with respect to the traditional laboratory analysis (i.e. troponin, MB-creatine-kinase, C-reactive protein). Besides these traditional biomarkers, growing data indicate potential laboratory indexes that can predict endothelial dysfunction, vascular thrombosis and platelet aggregation. However, their prognostic value is currently unknown. We describe the most widely used laboratory tools in coronary artery disease with potential prognostic power that could provide incremental predictive information in clinical practice.