Biomarkers in the emergency workup of chest pain: Uses, limitations, and future

Cleveland Clinic Journal of Medicine

Volumn 80, Issue 9, 2013, Pages 589-598

  Mosleh, Wassim ^a   Abdel Qadir, Husam ^b   Farkouh, Michael ^c,d  

^a TRINITY COLLEGE DUBLIN   (Ireland)

^b UNIVERSITY OF TORONTO   (Canada)

^c UNIVERSITY HEALTH NETWORK   (Canada)

^d UNIVERSITY OF TORONTO   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

BIOLOGICAL MARKER; BRAIN NATRIURETIC PEPTIDE; CST3 PROTEIN, HUMAN; CYSTATIN C; SERUM ALBUMIN; TROPONIN I; TROPONIN T;

BLOOD; HEART DISEASE; HUMAN; METABOLISM; REVIEW; SENSITIVITY AND SPECIFICITY; THORAX PAIN;

BIOLOGICAL MARKERS; CHEST PAIN; CYSTATIN C; HEART DISEASES; HUMANS; NATRIURETIC PEPTIDE, BRAIN; SENSITIVITY AND SPECIFICITY; SERUM ALBUMIN; TROPONIN I; TROPONIN T;

EID: 84887330041     PISSN: 08911150     EISSN: None     Source Type: Journal    
DOI: 10.3949/ccjm.80a.12112     Document Type: Review

References (50)

1. Pitts SR, Niska RW, Xu J, Burt CW. National hospital ambulatory medical care survey: 2006 emergency department summary. Natl Health Stat Report 2008; 1-38.
2. Vucic R, Knezevic S, Lazic Z, et al. Elevation of troponin values in differential diagnosis of chest pain in view of pulmonary thromboembolism. Vojnosanit Pregl 2012; 69:913-916.
3. Croitoru M, Taegtmeyer H. Spurious rises in troponin T in end-stage renal disease. Lancet 1995; 346:974.
4. Anderson JL, Adams CD, Antman EM, et al; 2011 Writing Group Members; ACCF/AHA Task Force Members. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 123:e426-e579.
5. Unstable angina: diagnosis and management. Guideline overview. Agency for Health Care Policy and Research. J Natl Med Assoc 1994; 86:649, 710-712.
6. Morrow DA, Cannon CP, Jesse RL, et al; National Academy of Clinical Biochemistry. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: clinical characteristics and utilization of biochemical markers in acute coronary syndromes. Circulation 2007; 115:e356-e375.
7. Hamm CW, Goldmann BU, Heeschen C, Kreymann G, Berger J, Meinertz T. Emergency room triage of patients with acute chest pain by means of rapid testing for cardiac troponin T or troponin I. N Engl J Med 1997; 337:1648-1653.
8. Heidenreich PA, Go A, Melsop KA, et al. Prediction of risk for patients with unstable angina. Evid Rep Technol Assess (Summ) 2000; August: 1-3.
9. Kontos MC, Fritz LM, Anderson FP, Tatum JL, Ornato JP, Jesse RL. Impact of the troponin standard on the prevalence of acute myocardial infarction. Am Heart J 2003; 146:446-452.
10. Amit G, Gilutz H, Cafri C, Wolak A, Ilia R, Zahger D. What have the new definition of acute myocardial infarction and the introduction of troponin measurement done to the coronary care unit? Impacts on admission rate, length of stay, case mix and mortality. Cardiology 2004; 102:171-176.
11. Alcalai R, Planer D, Culhaoglu A, Osman A, Pollak A, Lotan C. Acute coronary syndrome vs nonspecific troponin elevation: clinical predictors and survival analysis. Arch Intern Med 2007; 167:276-281.
12. Thygesen K, Mair J, Katus H, et al; Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. Recommendations for the use of cardiac troponin measurement in acute cardiac care. Eur Heart J 2010; 31:2197-2204.
13. Jaffe AS, Babuin L, Apple FS. Biomarkers in acute cardiac disease: the present and the future. J Am Coll Cardiol 2006; 48:1-11.
14. Jaeschke R, Guyatt GH, Sackett DL. Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. JAMA 1994; 271:703-707.
15. McDonald MA, Holroyd B, Comeau A, Hervas-Malo M, Welsh RC. Clinical risk scoring beyond initial troponin values: results from a large, prospective, unselected acute chest pain population. Can J Cardiol 2007; 23:287-292.
16. Than M, Cullen L, Reid CM, et al. A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospective observational validation study. Lancet 2011; 377:1077-1084.
17. Panju AA, Hemmelgarn BR, Guyatt GH, Simel DL. The rational clinical examination. Is this patient having a myocardial infarction? JAMA 1998; 280:1256-1263.
18. Amsterdam EA, Kirk JD, Bluemke DA, et al; American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology, Council on Cardiovascular Nursing, and Interdisciplinary Council on Quality of Care and Outcomes Research. Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association. Circulation 2010; 122:1756-1776.
19. Farkouh ME, Aneja A, Reeder GS, et al. Clinical risk stratification in the emergency department predicts long-term cardiovascular outcomes in a population-based cohort presenting with acute chest pain: primary results of the Olmsted county chest pain study. Medicine (Baltimore) 2009; 88:307-313.
20. Ohman EM, Armstrong PW, Christenson RH, et al. Cardiac troponin T levels for risk stratification in acute myocardial ischemia. GUSTO IIA Investigators. N Engl J Med 1996; 335:1333-1341.
21. Antman EM, Tanasijevic MJ, Thompson B, et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996; 335:1342-1349.
22. Sanchis J, Bodí V, Llácer A, et al. Predictors of short-term outcome in acute chest pain without ST-segment elevation. Int J Cardiol 2003; 92:193-199.
23. Gomez MA, Anderson JL, Karagounis LA, Muhlestein JB, Mooers FB. An emergency department-based protocol for rapidly ruling out myocardial ischemia reduces hospital time and expense: results of a randomized study (ROMIO). J Am Coll Cardiol 1996; 28:25-33.
24. Diercks DB, Gibler WB, Liu T, Sayre MR, Storrow AB. Identification of patients at risk by graded exercise testing in an emergency department chest pain center. Am J Cardiol 2000; 86:289-292.
25. Rahman F, Mitra B, Cameron PA, Coleridge J. Stress testing before discharge is not required for patients with low and intermediate risk of acute coronary syndrome after emergency department short stay assessment. Emerg Med Australas 2010; 22:449-456.
26. Kontos MC, Anderson FP, Alimard R, Ornato JP, Tatum JL, Jesse RL. Ability of troponin I to predict cardiac events in patients admitted from the emergency department. J Am Coll Cardiol 2000; 36:1818-1823.
27. Hoffmann U, Truong QA, Schoenfeld DA, et al; ROMICAT-II Investigators. Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med 2012; 367:299-308.
28. Hoffmann U, Bamberg F, Chae CU, et al. Coronary computed tomography angiography for early triage of patients with acute chest pain: the ROMICAT (Rule Out Myocardial Infarction using Computer Assisted Tomography) trial. J Am Coll Cardiol 2009; 53:1642-1650.
29. Goldstein JA, Chinnaiyan KM, Abidov A, et al; CT-STAT Investigators. The CT-STAT (Coronary Computed Tomographic Angiography for Systematic Triage of Acute Chest Pain Patients to Treatment) trial. J Am Coll Cardiol 2011; 58:1414-1422.
30. White CS, Kuo D, Kelemen M, et al. Chest pain evaluation in the emergency department: can MDCT provide a comprehensive evaluation? AJR Am J Roentgenol 2005; 185:533-540.
31. Redberg RF. Coronary CT angiography for acute chest pain. N Engl J Med 2012; 367:375-376.
32. Shreibati JB, Baker LC, Hlatky MA. Association of coronary CT angiography or stress testing with subsequent utilization and spending among Medicare beneficiaries. JAMA 2011; 306:2128-2136.
33. Aldous S, Pemberton C, Richards AM, Troughton R, Than M. Highsensitivity troponin T for early rule-out of myocardial infarction in recent onset chest pain. Emerg Med J 2012; 29:805-810.
34. Weber M, Bazzino O, Navarro Estrada JL, et al. Improved diagnostic and prognostic performance of a new high-sensitive troponin T assay in patients with acute coronary syndrome. Am Heart J 2011; 162:81-88.
35. Hochholzer W, Reichlin T, Twerenbold R, et al. Incremental value of high-sensitivity cardiac troponin T for risk prediction in patients with suspected acute myocardial infarction. Clin Chem 2011; 57:1318-1326.
36. Keller T, Zeller T, Ojeda F, et al. Serial changes in highly sensitive troponin I assay and early diagnosis of myocardial infarction. JAMA 2011; 306:2684-2693.
37. Reichlin T, Hochholzer W, Bassetti S, et al. Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med 2009; 361:858-867.
38. Reichlin T, Schindler C, Drexler B, et al. One-hour rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T. Arch Intern Med 2012; 172:1211-1218.
39. Newby LK. Myocardial infarction rule-out in the emergency department: are high-sensitivity troponins the answer?: Comment on "One-hour rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T". Arch Intern Med 2012; 172:1218-1219.
40. Haaf P, Reichlin T, Corson N, et al. B-type natriuretic peptide in the early diagnosis and risk stratification of acute chest pain. Am J Med 2011; 124:444-445.
41. Sun T, Wang L, Zhang Y. Prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes. Arch Med Res 2006; 37:502-505.
42. Galvani M, Ottani F, Oltrona L, et al; Italian Working Group on Atherosclerosis, Thrombosis, and Vascular Biology and the Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO). N-terminal pro-brain natriuretic peptide on admission has prognostic value across the whole spectrum of acute coronary syndromes. Circulation 2004; 110:128-134.
43. van der Zee PM, Cornel JH, Bholasingh R, Fischer JC, van Straalen JP, De Winter RJ. N-terminal pro B-type natriuretic peptide identifies patients with chest pain at high long-term cardiovascular risk. Am J Med 2011; 124:961-969.
44. Jernberg T, Lindahl B, James S, Larsson A, Hansson LO, Wallentin L. Cystatin C: a novel predictor of outcome in suspected or confirmed non-ST-elevation acute coronary syndrome. Circulation 2004; 110:2342-2348.
45. Akerblom Å, Wallentin L, Siegbahn A, et al. Cystatin C and estimated glomerular filtration rate as predictors for adverse outcome in patients with ST-elevation and non-ST-elevation acute coronary syndromes: results from the Platelet Inhibition and Patient Outcomes study. Clin Chem 2012; 58:190-199.
46. Anwaruddin S, Januzzi JL Jr, Baggish AL, Lewandrowski EL, Lewandrowski KB. Ischemia-modified albumin improves the usefulness of standard cardiac biomarkers for the diagnosis of myocardial ischemia in the emergency department setting. Am J Clin Pathol 2005; 123:140-145.
47. Senes M, Kazan N, Coskun O, Zengi O, Inan L, Yücel D. Oxidative and nitrosative stress in acute ischaemic stroke. Ann Clin Biochem 2007; 44:43-47.
48. Sabatine MS, Morrow DA, de Lemos JA, et al. Multimarker approach to risk stratification in non-ST elevation acute coronary syndromes: simultaneous assessment of troponin I, C-reactive protein, and B-type natriuretic peptide. Circulation 2002; 105:1760-1763.
49. Tello-Montoliu A, Marín F, Roldán V, et al. A multimarker risk stratification approach to non-ST elevation acute coronary syndrome: implications of troponin T, CRP, NT pro-BNP and fibrin D-dimer levels. J Intern Med 2007; 262:651-658.
50. Glaser R, Peacock WF, Wu AH, Muller R, Möckel M, Apple FS. Placental growth factor and B-type natriuretic peptide as independent predictors of risk from a multibiomarker panel in suspected acute coronary syndrome (Acute Risk and Related Outcomes Assessed With Cardiac Biomarkers [ARROW]) study. Am J Cardiol 2011; 107:821-826.