Cardiac markers allow you to quickly and correctly diagnose life-threatening cardiovascular diseases such as acute coronary syndrome (ACS) or acute heart failure. Cardiac enzymes are also the basic criteria for diagnosing a heart attack. What are markers of myocardial necrosis? In the diagnosis and treatment of which cardiovascular diseases are helpful?

Cardiac markersareenzymes , which play a key role in the diagnosis of heart disease, especially myocardial ischemia. Based on research usingbiological markers , a final diagnosis is made and appropriate treatment is undertaken.

Heart markers - what are they?

Cardiac markers , more preciselymyocardial necrosis markersare proteins produced exclusively by heart muscle cells (myocytes), the concentration of which in the blood increases when the heart muscle is damaged or overloaded, i.e. when the heart cell dies (necrosis) due to hypoxia.

Concentrations of individual markers increase, reach a maximum and return to normal levels at different times than the myocardial damage. Cardiac markers with a negative predictive value (NPV) can exclude acute cardiovascular disease, and markers with a high positive predictive value (PPV) are a useful tool for:

      • determining the size, shape, rhythm and overall heart rate
      • Recognizing and determining the extent of the heart damage and locating obstructed arteries
      • Assessing the risk of an unfavorable prognosis due to cardiac ischemia (e.g. death, recurrent ischemia, stroke, heart failure). However, they are most valued due to the early detection of myocardial infarction (possibility of early exclusion)

Cardiac enzymesare also helpful in determining the most appropriate treatment for a given patient. They also allow you to track the course of the disease.

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Heart markers - most often marked

Troponins(cTn) are proteins present in the heart muscle fibers whose task is to regulate the systolic-diastolic cycle of the heart and transverse musclesstriated. Due to their high sensitivity, cTn determinations have become the basis of the diagnostic process and risk assessment in acute coronary syndrome. They allow to recognize 2/3 of patients with ACS.

Their increase is already observed several hours after cardiac ischemia, and they reach their maximum values ​​approximately 24 hours after this event. They remain at elevated concentrations for about 7-10 days. Their value increases in the case of numerous, even minimal, heart injuries (contusion, ablation, pacemaker, burn, cardioversion, catheterization, cardiac surgery), heart attack, acute rheumatic fever, use cytostatics, congestive heart failure, extreme kidney failure, Pompe disease, heart transplant, hypertension, arrhythmia, hypothyroidism, pulmonary embolism and sepsis.Natriuretic peptideType B (BNP or NT-pro BNP) - its correct concentration allows to exclude heart failure in almost 100%. It is a good indicator of failure severity and a prognostic factor, correlating with the effectiveness of treatment.

CK-MB-creatine kinase MB- is one of the most popular markers of damage to heart muscle cells (myocytes). Thisheart enzymeis helpful in the diagnosis and treatment control of myocardial infarction (an increase in CK-MB activity in myocardial infarction is observed 4-6 hours after the onset of symptoms) of coronary artery disease, heart injury, skeletal muscle diseases, hypothyroidism, alcohol intoxication.

CK-MBmassis essential for the diagnosis of a heart attack. It begins to increase in the third to twelfth hours of the infarction. The maximum concentration is achieved in 24 hours. In addition to myocardial infarction, its increase is observed in rhabdomyolysis diseases such as progressive dystrophy, alcoholic myopathy, hypothyroidism, acute psychotic reactions, as well as after convulsions, certain medications or intramuscular injections.

Cardiac markers - indications for the test

The test is performed on patients with suspicion:

  • of acute coronary syndrome (ACS)
  • venous thromboembolism (VTE)
  • heart attack
  • ectopic pregnancy
  • incorrect digoxin level

And also in every other person who complains of chest pains, especially if they belong to the risk group, i.e. struggling with hypertension, diabetes, obesity.

Important

Self-made results have no value in themselves. They achieve diagnostic value after documenting myocardial ischemia, i.e. when assessed in relation to the conditionclinical condition of the patient, as well as after the analysis of changes in the ECG.

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