Abubakar Muhammad, Irfan Umema, Abdelkhalek Ahmad, Javed Izzah, Khokhar Muhammad Imran, Shakil Fraz, Raza Saud, Salim Siffat Saima, Altaf Muhammad Mahran, Habib Rizwan, Ahmed Simra, Ahmed Farea
Department of Internal Medicine, Ameer-Ud-Din Medical College, 6 Birdwood Road, Jinnah Town, Lahore, 54000, Punjab, Pakistan.
Department of Internal Medicine, Deccan College of Medical Sciences, Hyderabad, India.
J Cardiovasc Transl Res. 2024 Dec;17(6):1258-1285. doi: 10.1007/s12265-024-10540-8. Epub 2024 Jul 12.
Coronary artery disease (CAD), acute coronary syndrome (ACS), and heart failure (HF) are major global health issues with high morbidity and mortality rates. Biomarkers like cardiac troponins (cTn) and natriuretic peptides (NPs) are crucial tools in cardiology, but numerous new biomarkers have emerged, proving increasingly valuable in CAD/ACS. These biomarkers are classified based on their mechanisms, such as fibrosis, metabolism, inflammation, and congestion. The integration of established and emerging biomarkers into clinical practice is an ongoing process, and recognizing their strengths and limitations is crucial for their accurate interpretation, incorporation into clinical settings, and improved management of CVD patients. We explored established biomarkers like cTn, NPs, and CRP, alongside newer biomarkers such as Apo-A1, IL-17E, IgA, Gal-3, sST2, GDF-15, MPO, H-FABP, Lp-PLA2, and ncRNAs; provided evidence of their utility in CAD/ACS diagnosis and prognosis; and empowered clinicians to confidently integrate these biomarkers into clinical practice based on solid evidence.
冠状动脉疾病(CAD)、急性冠状动脉综合征(ACS)和心力衰竭(HF)是全球主要的健康问题,发病率和死亡率都很高。心肌肌钙蛋白(cTn)和利钠肽(NP)等生物标志物是心脏病学中的关键工具,但众多新的生物标志物不断涌现,在CAD/ACS中显示出越来越高的价值。这些生物标志物根据其作用机制进行分类,如纤维化、代谢、炎症和充血。将已有的和新出现的生物标志物整合到临床实践是一个持续的过程,认识到它们的优势和局限性对于准确解读、应用于临床环境以及改善心血管疾病(CVD)患者的管理至关重要。我们探讨了cTn、NP和CRP等已有的生物标志物,以及载脂蛋白A1(Apo-A1)、白细胞介素-17E(IL-17E)、免疫球蛋白A(IgA)、半乳糖凝集素-3(Gal-3)、可溶性生长刺激表达基因2蛋白(sST2)、生长分化因子15(GDF-15)、髓过氧化物酶(MPO)、心脏型脂肪酸结合蛋白(H-FABP)、脂蛋白相关磷脂酶A2(Lp-PLA2)和非编码RNA(ncRNAs)等新的生物标志物;提供了它们在CAD/ACS诊断和预后中的应用证据;并使临床医生能够基于确凿的证据自信地将这些生物标志物整合到临床实践中。