Wood Frances O, de Lemos James A
Cardiovascular Division and Department of Internal Medicine, UT Southwestern Medical Center, 5909 Harry Hines Boulevard, HA 9.108, Dallas, TX 75390-9047, USA.
Curr Cardiol Rep. 2008 Jul;10(4):319-26. doi: 10.1007/s11886-008-0051-z.
Early diagnosis of acute coronary syndromes (ACS) allows for efficient risk stratification, appropriate targeted therapies, and faster patient disposition within crowded emergency departments. Although only troponin testing is recommended for routine use in the 2007 American College of Cardiology/American Heart Association guidelines for non-ST-elevation ACS, emerging data support selected use of other biomarkers, including B-type natriuretic peptides (BNPs) and C-reactive protein. There remains a need to identify additional biomarkers in ACS to enhance risk stratification and to help guide therapeutic decisions in this increasingly complex area of cardiovascular medicine. Cardiac biomarkers may help to diagnosis ACS before cardiomyocyte necrosis, to influence the decision for early invasive treatment, and to provide a means of monitoring response to therapy. In this review, we assess new data in ACS with respect to troponins, BNPs, myeloperoxidase, fatty acid-binding protein, and monocyte chemoattractant protein-1. We also discuss novel biomarkers including growth deficient factor-15 and neopterin.
急性冠脉综合征（ACS）的早期诊断有助于进行有效的风险分层、采取恰当的靶向治疗，并在拥挤的急诊科中更快地安排患者处置。尽管在2007年美国心脏病学会/美国心脏协会关于非ST段抬高型ACS的指南中仅推荐肌钙蛋白检测用于常规检查，但新出现的数据支持选择性使用其他生物标志物，包括B型利钠肽（BNP）和C反应蛋白。在ACS中仍需要鉴定更多生物标志物，以加强风险分层，并在这个日益复杂的心血管医学领域帮助指导治疗决策。心脏生物标志物可能有助于在心肌细胞坏死之前诊断ACS，影响早期侵入性治疗的决策，并提供一种监测治疗反应的手段。在本综述中，我们评估了关于肌钙蛋白、BNP、髓过氧化物酶、脂肪酸结合蛋白和单核细胞趋化蛋白-1的ACS新数据。我们还讨论了包括生长分化因子-15和蝶呤在内的新型生物标志物。
