McDonnell Barry, Hearty Stephen, Leonard Paul, O'Kennedy Richard
Biomedical Diagnostics Institute, Dublin City University, Dublin, Ireland.
Clin Biochem. 2009 May;42(7-8):549-61. doi: 10.1016/j.clinbiochem.2009.01.019. Epub 2009 Feb 7.
Cardiovascular disease (CVD) is the single greatest cause of adult mortality in the western world and, consequently, places a massive burden on healthcare services and the economy. Lifestyles, lack of clearly defined risk assessment criteria, consistently high incidences of misdiagnosis and inappropriate referrals, all contribute significantly to this problem. It also correlates directly with inefficient or non-accessible early detection systems. Over the last decade much research has focused on the identification of cardiac biomarkers that can be used for the detection of cardiac distress and that add value to current risk stratification criteria. An exposition of some of the most consistently cited biomarkers is provided and their current status and potential value as early CVD risk predictors, more accurate diagnostic markers of acute myocardial damage and as reliable prognostic indicators, is evaluated. The particular importance of early prediction and the integral role that point-of-care (POC) testing is expected to play in the future of cardiac care is critically discussed.
心血管疾病(CVD)是西方世界成年人死亡的单一最大原因,因此给医疗服务和经济带来了巨大负担。生活方式、缺乏明确界定的风险评估标准、持续高发的误诊和不适当转诊,都对这一问题有重大影响。它还与低效或难以获得的早期检测系统直接相关。在过去十年中,许多研究都集中在识别可用于检测心脏窘迫并为当前风险分层标准增加价值的心脏生物标志物上。本文阐述了一些被频繁引用的生物标志物,并评估了它们作为早期心血管疾病风险预测指标、急性心肌损伤更准确诊断标志物以及可靠预后指标的当前状况和潜在价值。还批判性地讨论了早期预测的特殊重要性以及即时检测(POC)在未来心脏护理中预期发挥的不可或缺的作用。