Introduction:

Myocardial infarction (MI), commonly known as a heart attack, is a serious cardiovascular event that requires prompt diagnosis and appropriate management. Serum markers or biomarkers are specific substances in the blood that can aid in the diagnosis and monitoring of myocardial infarction. This article provides a comprehensive guide to the commonly used serum markers for myocardial infarction, their clinical significance, and their role in patient care.

Troponin:

• Troponin I (cTnI) and Troponin T (cTnT) are cardiac-specific proteins released into the bloodstream when heart muscle cells are damaged.
• Troponin is the gold standard biomarker for diagnosing myocardial infarction due to its high specificity and sensitivity.
• Elevated troponin levels help confirm the diagnosis of myocardial infarction and guide treatment decisions.
• Troponin levels rise within a few hours of symptom onset, peak within 24-48 hours, and may remain elevated for several days.

Creatine Kinase-MB (CK-MB):

• CK-MB is an enzyme predominantly found in cardiac muscle cells.
• Elevated CK-MB levels in the blood indicate myocardial injury and are useful in diagnosing myocardial infarction.
• However, CK-MB is less specific than troponin and has been largely replaced by troponin in clinical practice.

Myoglobin:

• Myoglobin is a protein found in cardiac and skeletal muscle cells.
• Elevated myoglobin levels in the blood can be detected early after myocardial injury.
• Although less specific than troponin, myoglobin can be used as an additional marker in the early diagnosis of myocardial infarction.

C-reactive Protein (CRP):

• High-sensitivity C-reactive protein (hs-CRP) is an inflammatory marker associated with cardiovascular risk.
• Elevated hs-CRP levels may indicate an increased risk of developing cardiovascular disease, including myocardial infarction.
• Monitoring hs-CRP levels can help assess the inflammatory response and guide treatment strategies.

Natriuretic Peptides:

• B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are released by the heart in response to increased cardiac wall stress.
• Elevated BNP and NT-proBNP levels can indicate myocardial damage and help assess the severity of myocardial infarction.
• These biomarkers are also useful in evaluating heart failure and guiding treatment decisions.

Conclusion:

Serum markers play a crucial role in the diagnosis and management of myocardial infarction. Troponin is the preferred and most specific biomarker for detecting myocardial injury. CK-MB, myoglobin, hs-CRP, and natriuretic peptides provide additional information to support the diagnosis, risk stratification, and monitoring of patients with myocardial infarction. Integrating clinical findings with serum marker results allows healthcare providers to deliver appropriate and timely care to individuals experiencing a heart attack.

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