Evaluating the kinetics of cardiac biomarkers after ST-segment Elevation myocardial infarction.
EMERGE Research team
Cardiology Research Group
Background: Cardiac troponins are integral to the diagnosis of myocardial infarction, and plasma concentrations are used routinely in clinical practice to determine the extent of myocardial injury and to guide prognosis.(1) The latest generation of high-sensitivity assays are now able to measure very low concentrations of cardiac troponin even in healthy individuals, and as such these assay will permit a more accurate evaluation of the release and clearance of cardiac troponins from the circulation following myocardial infarction.(2)
Understanding the kinetics of cardiac biomarker release in patients with myocardial infarction will help clinicians to interpret cardiac troponins in patients who represent with recurrent symptoms, and may help us to identify patients at increased risk of adverse remodelling and subsequent heart failure.
• What factors influence the magnitude and time course of cardiac troponin release and clearance in patients with suspected or confirmed myocardial infarction
• Are there differences in troponin release kinetics between patients with ST-segment and Non-ST segment elevation myocardial infarction?
• Does the magnitude and time course of troponin release differ by age and gender?
• How does microvascular obstruction influence the release and clearance of cardiac troponin in patients undergoing percutaneous coronary intervention?
• How does the release and clearance of cardiac troponins compare to other biomarkers of myocardial injury?
• Is peak troponin concentration or a composite measure (area under the curve) a better predictor of left ventricular systolic dysfunction?
Prospective cohort study
Patients who present to the Emergency Department with suspected heart disease
Honorary Professor of Emergency Medicine & Clinical Director of the Emergency Department