A biomarker test for an enzyme, protein, or hormone for the heart is the primary test healthcare providers use to assess damage from a heart attack. This is a very important test that helps in diagnosis, treatment with precision medicine or in the decision to proceed with surgery, and prevention. Outcomes are patient-specific.
Biomarkers for cardiovascular risk
Recent investigation has shown the predictive power for incident cardiovascular disease of the circulating cardiac markers, including cardiac troponin T, cardiac troponin I, and N-terminal proBNP (NT-proBNP), which have been validated in large populations. Blood pressure and cholesterol levels are known to be predictive tools for the onset of cardiovascular disease (CVD) in certain heart conditions. The primary precaution for CVD depends on the ability to identify high-risk individuals. Cardiovascular biomarker research has identified risk factors and novel drug targets for the establishment of treatment guidelines for cardiovascular disease. The European Medical Association (EMA) and the United States Food and Drug Administration (US FDA) rely on biomarkers to support the clinical applications of CVD.
Cardiac biomarkers used to diagnose a heart attack
Cardiac biomarkers show up in the blood after the heart has been under the influence of severe stress and becomes damaged because of the lack of sufficient oxygen. The levels of biomarkers like the ones mentioned below are often used to quickly find out the severity of a heart attack.
Cardiac troponin: Cardiac troponin is the most frequently used biomarker as it has the highest known sensitivity. It is the best biomarker for finding a heart attack. Cardiac troponin enters the bloodstream as soon as a heart attack occurs and stays in the bloodstream for days after all other biomarkers have gone down to normal levels. Two other forms of troponin that may be measured include troponin T and troponin I. Troponin I is extremely specific to the heart and is present longer than creatinine kinase-MB (CK-MB).
Creatinine kinase (CK): The CK enzyme is measured several times over 24 hours. In the advent of a heart attack, the levels of CK will often double. This enzyme is not very specific, as higher levels of CK will be seen in many other conditions other than a heart attack.
Creatine kinase-myoglobin binding (CK-MB): CK-MB is a subtype of CK and is more sensitive to finding heart damage from a heart attack. After a heart attack, the CK-MB level rises within 4 to 6 hours. The levels generally return to normal in a day or two. Therefore, in the case of chest pain, it is not very helpful for a healthcare provider to try to figure out whether the recent chest pain was a heart attack or not.
Myoglobin: Myoglobin is a small protein that stores oxygen. It is measured occasionally and is not very specific for finding a heart attack. Myoglobin levels are sometimes measured in combination with the levels of troponin for increased specificity to help diagnose a heart attack.
A biomarker test measures the levels of cardiac biomarkers present in a patient’s blood. These cardiac biomarkers are seen after a heart attack, and thus, these tests are recommended by the healthcare provider in the case of having had a heart attack, having recently had a heart attack, or the appearance of symptoms of coronary artery blockage.
- Wong, Y. K., & Tse, H. F. (2021). Circulating Biomarkers for Cardiovascular Disease Risk Prediction in Patients With Cardiovascular Disease. Frontiers in cardiovascular medicine, 8, 713191. https://www.frontiersin.org/articles/10.3389/fcvm.2021.713191/full
- Perticone, M., Molfino, A., & Maio, R. (2022). Editorial: Classical and Novel Biomarkers for Cardiovascular Disease. Frontiers in cardiovascular medicine, 9, 943227. https://www.frontiersin.org/articles/10.3389/fcvm.2022.943227/full
- Cardiac Biomarkers (Blood). Health Encyclopedia. UNIVERSITY OF ROCHESTER MEDICAL CENTER. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=cardiac_biomarkers