Cardiac biomarkers: Present and future

Abstract

Cardiovascular diseases are currently considered the most signifi cant pandemic of the XXI century. Among them, coronary disease is the most prevalent and the one that generates more morbidity and mortality. In Colombia, is the main cause of death in individuals over 45 years. The silent characteristics of this disease has promoted research of molecules that allow early diagnosis and serve as predictors of prognosis both in chronic and acute phases. As result of this research, there has been signifi cant progress in the development of cardiac biomarkers in the last thirty years. Among them are the newly developed ultrasensitive troponin assays for an early diagnosis, measurement of ischemia modifi ed albumin, which has high negative predictive value for the detection of myocardial ischemia, soluble CD40 ligand for classifi cation and individualization of treatment, the usefulness of CRP as a risk marker for coronary heart disease and various high-throughput techniques such as proteomics, which allow the detection of multiple potential biomarkers. Despite this, there is still insuffi cient evidence for replacing the markers recommended by the scientifi c associations by new developed markers, and the debate about what combination to use in order to achieve higher performance diagnosis, prognosis and therapy, continues Here we review current advances in cardiac biomarkers and their potential integration into daily clinical practice.