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Received on December 2, 2004
Accepted on March 4, 2005
Review |
1 Department of Laboratory Medicine and Pathology, Hennepin County Medical Center, Minneapolis, MN
2 Department of Laboratory Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA
3 Clinical Division of Cardiology, Medical University Innsbruck, Innsbruck Austria
4 Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aarhus, Denmark
5 Laboratorio Analisi Chimico Cliniche 1, Azienda Ospedaliera Spedali Civili, Brescia, Italy
6 Department of Chemical Pathology, Queensland Health Pathology Service, Princess Alexandra Hospital, Brisbane, Australia
7 Department of Pathology, University of Maryland, Baltimore, MD
8 Medicine
9 Cardiology, University Hospital Charite, Berlin, Germany
* To whom correspondence should be addressed. E-mail: fred.apple{at}co.hennepin.mn.us.
Approach and Content: The purpose of this review is to provide an overview of the pathophysiology and clinical and analytical characteristics of several biomarkers that may have potential clinical utility to identify ACS patients. These biomarkers (myeloperoxidase, metalloproteinase-9, soluble CD40 ligand, pregnancy-associated plasma protein A, choline, ischemia-modified albumin, unbound free fatty acids, glycogen phosphorylase isoenzyme BB, and placental growth factor) have demonstrated promise and need to be more thoroughly evaluated for commercial development for implementation into routine clinical and laboratory practice.
Summary: Specifications that have been addressed for cardiac troponins and natriuretic peptides will need to be addressed with the same scrutiny for the biomarkers discussed in this review. They include validating analytical imprecision and detection limits, calibrator characterization, assay specificity and standardization, preanalytical issues, and appropriate reference interval studies. Crossing boundaries from research to clinical application will require replication in multiple settings and experimental evidence supporting a pathophysiologic role and, ideally, interventional trials demonstrating that monitoring single or multiple biomarkers improves outcomes.
The following articles in journals at HighWire Press have cited this article:
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