Advances in Cardiac Biomarkers

The use of cardiac biomarkers for the diagnosis and risk stratification of patients in the emergency department (ED) is evolving rapidly. Previously, the role of cardiac enzymes was restricted to the diagnosis of acute myocardial infarction (AMI). The identification of new biomarkers and more sensitive assays has extended the use of biomarkers beyond the diagnosis of cardiac necrosis. As novel biomarkers are identified, emergency physicians should be aware of both the potential clinical usefulness and the limitations of promising biomarkers. Testing should always be guided by a patient’s history and physical examination to avoid misusing biomarkers as ‘‘screening’’ tools in critically ill patients. This update focuses on the present and future value of cardiac biomarkers in the care of patients who have suspected cardiac and cardiac-related diseases in the emergency department.