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Clinical Chemistry 55: 12-14, 2009. First published November 21, 2008; 10.1373/clinchem.2008.118208
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(Clinical Chemistry. 2009;55:12-14.)
© 2009 American Association for Clinical Chemistry, Inc.

Editorials

Novel Biomarkers of Cardiovascular Disease: Myeloperoxidase for Acute and/or Chronic Heart Failure?

Alan H.B. Wu

Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, Address correspondence to the author at:, San Francisco General Hospital Clinical Chemistry Laboratory, 1001 Potrero Ave, San Francisco, CA, 94110, Fax 415-206-3045, E-mail wualan@labmed2.ucsf.edu

The first 20% of the full text of this article appears below.

Cardiac biomarkers continue to play a prominent role in the diagnosis and management of patients who present to the emergency department with symptoms suggestive of acute cardiovascular disease. The use of cardiac troponin was reaffirmed in 2007 by the European Society of Cardiology, American College of Cardiology, American Heart Association, and World Heart Federation as the single most important biomarker for diagnosis of acute myocardial infarction (1). For acute decompensated heart failure (ADHF),1 the American College of Cardiology and American Heart Association have opined that "measurement of B-type natriuretic peptide (BNP) can be useful in the evaluation of patients presenting in the urgent care setting in whom the clinical diagnosis of heart failure is uncertain (level of evidence: A)" (2). Despite these advancements, some clinical needs are not met by measurement of troponin and the natriuretic peptides. For acute coronary syndrome, novel biomarkers are needed for the early diagnosis of acute myocardial infarction, e.g., at the time of emergency department presentation. Biomarkers are also needed for risk stratification for future short-term (30 days) adverse cardiac events (death and acute myocardial infarction). For acute heart failure, new laboratory tests are needed to complement B-type natriuretic peptide and N-terminal pro–B-type natriuretic peptide, because these markers are influenced by obesity, renal failure, and pulmonary disease (3).

In general, 2 strategies are employed for the discovery of novel biomarkers. The proteomic/metabolomic approach compares . . . [Full Text of this Article]






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