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  • Review Article
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Cardiac biomarkers: a contemporary status report

Nature Clinical Practice Cardiovascular Medicine volume 3, pages 24–34 (2006)Cite this article

A Corrigendum to this article was published on 01 May 2006

Abstract

The field of cardiac biomarkers has grown by leaps and bounds in the past two decades. In this review we try to summarize the explosion of emerging knowledge and address the roles of some of the biomarkers that have either proven or potential utility. We detail some of the markers of ischemia, hemodynamic markers of heart failure, inflammatory markers, and the novel and innovative approach of combining these for a multimarker strategy. At the end of this review we highlight some of the biomarker-guided approaches and strategies that might lead to better and more-effective care of patients.

Key Points

  • Blood tests are now available for several markers to be used as adjuncts in primary prevention and screening, and in diagnostic, prognostic and therapeutic strategies for cardiovascular disease

  • Biomarkers could provide noninvasive insight into the underlying causes and consequences of acute coronary syndromes to reduce myocardial injury by early diagnosis and treatment

  • Assessment of biomarkers has value and potential in the risk stratification of myocardial ischemia patients

  • The prognostic value of biomarkers can be increased by use of multimarker strategies, in which each biomarker provides insight into a different pathophysiologic axis

  • A role might exist for biomarkers in the targeting of therapy, but further prospective study is needed in a clinical setting

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Figure 1: Cardiac markers classified according to the different pathologic processes they indicate.
Figure 2: Predictive value of cardiac troponin I concentrations at presentation for short-term mortality in patients with acute coronary syndromes.
Figure 3: Relationship between brain natriuretic protein concentrations by quartile and risk of mortality in patients with acute coronary syndromes.
Figure 4: Relationship of brain natriuretic peptide and diagnosis of acute decompensated heart failure, expressed as area under receiver-operating-characteristic curve.
Figure 5: Association between myelopyroxidase serum levels in different tertiles and cardiac event rate in patients with acute coronary syndromes short term and long term after onset.
Figure 6: Mortality risk at 30 days after onset of acute coronary syndromes, assessed by measurement of no, single and multiple cardiac biomarkers.
Figure 7: Possible routes of research into biomarker-guided, individualized management strategies.
Figure 8: Association of predischarge brain natriuretic peptide levels and risk of rehospitalization or death during 6-month follow-up.
Figure 9: Clinical relevance of achieved level of low-density lipoprotein cholesterol and C-reactive protein concentration after treatment with statins for recurrent myocardial infarction or death in long-term follow-up.
Figure 10: Association between adiponectin concentrations in different quintiles and risk of myocardial infarction in 532 men aged 4575 years during 6-year follow-up.

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Author information

Authors and Affiliations

  1. Department of Medicine, Veterans Affairs San Diego Healthcare System and University of California, San Diego, CA

    Alan S Maisel, Vikas Bhalla & Eugene Braunwald

  2. Harvard Medical School, Brigham and Womens Hospital, Boston, MA, USA

    Alan S Maisel, Vikas Bhalla & Eugene Braunwald

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  1. Alan S Maisel
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  2. Vikas Bhalla
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  3. Eugene Braunwald
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Correspondence to Alan S Maisel.

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Maisel, A., Bhalla, V. & Braunwald, E. Cardiac biomarkers: a contemporary status report. Nat Rev Cardiol 3, 24–34 (2006). https://doi.org/10.1038/ncpcardio0405

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