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In the setting of an acute coronary syndrome cardiac troponins are well established for the diagnosis of myocardial infarction. In particular, diagnostic protocols using high-sensitivity troponin assays are being recommended for earlier diagnosis of MI by the European Society of Cardiology (ESC) guidelines on the management of ACS without ST segment elevation. In addition to accurate detection of myocardial necrosis, cardiac troponins give complementary information on short- and long-term prognosis and facilitate the identification of patients who derive benefits from a more aggressive anticoagulation and/or early invasive therapy versus conservative therapy. Other cardiac biomarkers may help to improve earlier diagnosis or improve risk stratification. Their role is currently under investigation. The present state-of-the-art paper gives an overview on the role of cardiac troponins including recent recommendations on the use of high-sensitivity assays from the third version of the Joint ESC/ACCF/AHA/WHF infarct definition “Universal MI definition” and the ESC guidelines. In addition, an overview on the role of novel cardiac biomarkers in earlier diagnosis or risk stratification is provided.

Cardiovascular Biomarkers in ACS: State of the Art 2012