Department of Medicine and Cardiology, Aarhus University Hospital, Tage-Hansens Gade 2, DK-8000 Aarhus C, Denmark.
Eur Heart J. 2010 Sep;31(18):2197-204. doi: 10.1093/eurheartj/ehq251. Epub 2010 Aug 3.
The release of cardiomyocyte components, i.e. biomarkers, into the bloodstream in higher than usual quantities indicates an ongoing pathological process. Thus, detection of elevated concentrations of cardiac biomarkers in blood is a sign of cardiac injury which could be due to supply-demand imbalance, toxic effects, or haemodynamic stress. It is up to the clinician to determine the most probable aetiology, the proper therapeutic measures, and the subsequent risk implied by the process. For this reason, the measurement of biomarkers always must be applied in relation to the clinical context and never in isolation. There are a large number of cardiac biomarkers, but they can be subdivided into four broad categories, those related to necrosis, inflammation, haemodynamic stress, and/or thrombosis. Their usefulness is dependent on the accuracy and reproducibility of the measurements, the discriminatory limits separating pathology from physiology, and their sensitivity and specificity for specific organ damage and/or disease processes. In recent years, cardiac biomarkers have become important adjuncts to the delivery of acute cardiac care. Therefore, the Working Group on Acute Cardiac Care of the European Society of Cardiology established a committee to deal with ongoing and newly developing issues related to cardiac biomarkers. The intention of the group is to outline the principles for the application of various biomarkers by clinicians in the setting of acute cardiac care in a series of expert consensus documents. The first of these will focus on cardiac troponin, a pivotal marker of cardiac injury/necrosis.
心肌细胞成分（即生物标志物）大量释放到血液中表明存在持续的病理过程。因此，血液中心脏生物标志物浓度升高是心肌损伤的标志，可能是由于供需失衡、毒性作用或血流动力学应激引起的。临床医生需要确定最可能的病因、适当的治疗措施以及该过程所涉及的后续风险。出于这个原因，生物标志物的测量必须始终与临床情况相关联，而不能孤立进行。有大量的心脏生物标志物，但它们可以分为四大类，与坏死、炎症、血流动力学应激和/或血栓形成有关。它们的有用性取决于测量的准确性和可重复性、区分病理与生理的临界值，以及对特定器官损伤和/或疾病过程的敏感性和特异性。近年来，心脏生物标志物已成为急性心脏护理的重要辅助手段。因此，欧洲心脏病学会急性心脏护理工作组成立了一个委员会，负责处理与心脏生物标志物相关的持续和新出现的问题。该小组的目的是在一系列专家共识文件中概述临床医生在急性心脏护理环境中应用各种生物标志物的原则。其中第一份文件将重点关注心肌钙蛋白，这是心肌损伤/坏死的关键标志物。
