Prognostic Biomarkers in Acute Coronary Syndromes: Risk Stratification Beyond Cardiac Troponins.
PURPOSE OF REVIEW
Cardiac troponin (cTn) plays an essential role for assessment of outcome in acute coronary syndrome (ACS). However, the prognostic value of cTn is not absolute. In this mini-review, we summarize the evidence on the utility of established biomarkers of left-ventricular dysfunction, hemodynamic stress, inflammation, and renal dysfunction for risk prediction beyond cTn in ACS.


RECENT FINDINGS
Only few biomarkers consistently demonstrate additive prognostic value to cTn levels. The B-type natriuretic peptides (NPs) and growth-differentiation factor-15 (GDF-15) are most promising in this regard. However, there are uncertainties regarding the role of these biomarkers for guidance of treatment decisions, and their prognostic increment to cTn levels measured with high-sensitivity assays is largely unknown. The NPs and GDF-15 provide the strongest prognostic increment to cTn levels in ACS. However, the role of these biomarkers for clinical decision-making in contemporary settings has still to be defined.
['Eggers|K M|KM|', 'Lindahl|B|B|']
D054058:Acute Coronary Syndrome D015415:Biomarkers D055436:Growth Differentiation Factor 15 D006801:Humans D007249:Inflammation D007674:Kidney Diseases D009203:Myocardial Infarction D020097:Natriuretic Peptide, Brain D011379:Prognosis D014336:Troponin D018487:Ventricular Dysfunction, Left
Biomarkers Acute coronary syndrome Risk prediction