We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Biomarkers in emergency cardiology: cardio-pulmonary resuscitation, acute coronary syndromes, pulmonary thromboembolism, acute aortic syndrome and acute heart failure.
- Authors
Petris, Antoniu Octavian; Tatu-Chitoiu, Gabriel; Coman, Ioan Mircea; Tint, Diana; Christodorescu, Ruxandra; Chioncel, Valentin; Darabantiu, Dan; Cimpoesu, Diana; Antohi, Laura; Sorodoc, Laurentiu; Petrescu, Lucian; Pop, Calin; Mebazaa, Alexandre; Chioncel, Ovidiu
- Abstract
Biomarkers have been accepted into daily clinical practice for several decades and are now widely used in the fi eld of emergency cardiology, as a tool for quick diagnosis of some acute critical conditions requiring an early and adequate therapeutic approach. At fi rst, they were frowned upon ("guessing in the blood sample") and then they were used indiscriminately (creating a new so-called disease -"troponinitis" etc). Utilization for diagnosis, risk stratifi cation or treatment strategy purposes requires an appropriate selection of the biomarkers, assuming specific variations in different clinical conditions. The development of these biomarkers have often caused another problem concerning the need for a more cautious interpretation, adapted to the type of patient with single-organ vs multi-organ failure who will require a quantitative multimarker high sensitivity approach: in this case point-of-care assessment is not enough. Reviewing the latest European Society of Cardiology (ESC) and European Resuscitation Council (ERC) Guidelines on acute cardio-vascular conditions (ESC Guidelines for STEMI- 2012, ESC Guidelines for acute pulmonary thromboembolism and Guidelines on the diagnosis and treatment of aortic diseases date from 2014, ESC Guidelines for NSTEMI and cardiac arrest from 2015 and ESC/HFA Guidelines for acute heart failure from 2016) we noticed the considerable proportion achieved by biomarkers as components of decision making in diagnostic, prognostic and therapeutic approaches. Some biomarkers are mentioned in almost all of these Guidelines (natriuretic proteins and cardiac troponins), while copeptin, H-FABP and GFD-15 are more and more frequently referenced in different acute critical conditions and obviously, a number of particular biomarkers are specific only to certain acute situations (e.g. NSE, S100B in resuscitation, ST2, adrenomedullin and galactin-3 in heart failure). Clearly, it has lately become difficult to contest the role of biomarkers as biological signals that have to be taken into account in daily practice.
- Subjects
CARDIOVASCULAR emergencies; CARDIOPULMONARY resuscitation; HEART failure
- Publication
Romanian Journal of Cardiology, 2017, Vol 27, Issue 3, p333
- ISSN
1220-658X
- Publication type
Article