Biochemical markers in the diagnosis of myocardial infarction

The diagnosis of myocardial necrosis due to acute myocardial infarction (AMI) and other causes has long been based on the plasma levels of cardiac troponins. Other markers of myocardial injury such as myoglobin, heart-type fatty acid binding protein, glycogen phosphorylase isoenzyme BB, or the early and sensitive total stress marker copeptin remain to be just attractive options used primarily to early rule out AMI and in risk stratification. Recent years have seen the introduction of a routine practice of the high-sensitivity cardiac troponin assays capable of detecting diagnostic elevations in plasma troponin levels as early as the first hours of myocardial injury. However, this assay tends to identify very often low plasma troponin levels in primarily noncardiac conditions and also in healthy or apparently healthy individuals. Hence, this novel technology warrants further study.