Myocardial Damage : Biochemical markers

Heart diseases, particularly coronary artery diseases (CAD), are the leading causes of morbidity and mortality in developed countries. The management of acute ischemic events, such as myocardial infarction (MI), relies heavily on rapid and accurate diagnosis to initiate effective therapy. This timely intervention is crucial for patient survival and the prevention of long-term complications.

Over the decades, significant advancements have been made in the identification and application of biochemical markers for diagnosing myocardial ischemia and infarction. Early markers, such as aspartate aminotransferase (AST) in the 1950s, were gradually replaced by more cardiac-specific enzymes like lactate dehydrogenase (LDH) and creatine kinase (CK), along with their isoenzymes. The development of immunoassays further expanded the range of detectable markers, including non-enzymatic proteins. However, these early markers had limitations in tissue specificity and sensitivity, which affected their diagnostic accuracy.

The discovery of cardiac-specific troponins I and T marked a significant breakthrough in the diagnosis of myocardial ischemia and infarction. These proteins demonstrated high specificity and sensitivity for cardiac injury, surpassing earlier markers. As a result, troponins have become the gold standard for diagnosing acute coronary syndromes. The widespread use of troponins has also facilitated the redefinition of myocardial injury and expanded the understanding of...