BJA Advance Access originally published online on April 19, 2004
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British Journal of Anaesthesia, 2004, Vol. 93, No. 1 63-73
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia
Biochemical markers of myocardial injury
1 Department of Clinical Biochemistry, Royal Brompton Hospital, London SW3 6NP, UK. 2 Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
*Corresponding author. E-mail: m.kemp@rbh.nthames.nhs.uk
Keywords: complications, myocardial injury; heart, cardiac marker
| The first 150 words of the full text of this article appear below. |
The first account of the use of a biochemical marker in the study of myocardial injury was published by La Due and colleagues in the journal Science in 1954.85 They measured serum glutamate oxaloacetic transaminase activity from a few hours to up to 15 days in a group of patients immediately after an acute myocardial infarction (AMI). They reported that enzyme activity increased above the reference range a few hours after AMI, reached a peak after 2 or 3 days, and then returned to baseline within a week. This work stimulated interest in the development of analytical procedures for other suitable marker proteins, and in their clinical applications. The development of assays for new marker proteins has contributed to a greater understanding of the pathophysiology of the disease spectrum of acute coronary syndromes, helped in their definition and assisted in cardiac risk stratification.
Characteristics of a cardiac marker
The ideal characteristics of a cardiac marker
Biochemical markers (Table 2)
Cardiac enzymes
Creatine kinase and CK-MB isoenzyme
Creatine kinase isoforms
Myoglobin
Carbonic anhydrase III
Glycogen phosphorylase BB
Heart fatty acid binding protein
Myosin light chains
Cardiac troponins
Brain natriuretic peptide
Ischaemia modified albumin
Markers of inflammation
Perioperative myocardial injury
Cardiac markers and perioperative myocardial injury
Conclusions
Appendix: proposed ESC/ACC definition of an MI4
Criteria for acute, evolving, or recent MI
Criteria for established MI
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