Acute coronary syndromes: from the laboratory markers to the coronary vessels

Abstract

A number of "interesting" risk markers have been proposed as providing prognostic informations in acute coronary syndromes (ACS). Elevation in plasma inflammatory and necrosis biomarkers have been related to future cardiovascular events in individuals with or without prior myocardial infarction. Recently BNP and pro-BNP are entered in clinical practice to recognize patients at major risk, providing incremental information respect to the traditional markers. Together with these laboratory indexes, a few of promising laboratory markers once easily available, could become usefull in identification of patients at high risk.Several studies evaluated many markers of platelet aggregation, endothelial dysfunction and vascular thrombosis, but it is not yet clear whether each of the proposed markers may provide incremental predictive information.We describe, following the most studies reported in literature, the laboratory markers with potential clinical and prognostic power that could early help physicians in the identification of patients with impaired coronary disease and more narrowed coronary arteries.

Keywords: B-type natriuretic peptide; C-reactive protein; Coronary disease; Troponin.

Figure 1

Traditional and novel laboratory risk markers and their potential clinical significance.

Figure 2

Biomarkers of endothelial dysfunction and their specific actions in atherosclerotic process.