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The use of biomarkers for acute cardiovascular disease 

The use of biomarkers for acute cardiovascular disease
Chapter:
The use of biomarkers for acute cardiovascular disease
Author(s):

Allan S Jaffe

DOI:
10.1093/med/9780199687039.003.0035_update_002

Update:

Added 4 new references

Recent data suggesting that acute heart failure differs from chronic heart failure in that there is less deglycosylation with chronic failure leading to a greater surfeit of active BNP 1–32

Data that values for hscTnT are reduced in hemolysed samples

Clarified that all hscTn assays manifest differences between the 99th%URl between men and women

An alert in regard to the differences in natriuretic peptide values with Neprelysin inhibition

Updated on 22 February 2018. The previous version of this content can be found here.
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date: 22 October 2019

Understanding the proper use of biomarkers requires clinicians to appreciate some critical pre-analytic and analytic issues, as well as how to use the markers properly. The bene?ts of such an approach will not only facilitate the care of patients today, but will also prepare clinicians to understand and embrace the new generation of markers that is coming and that will continue to make this area transformational for cardiology. Two fundamental concepts underlie the clinical use of biomarkers: First, biomarkers should always be used in conjunction with all other clinical information. Second, in order to maximize their diagnostic and prognostic use, biomarkers should be interpreted as quantitative variables. For example, a cardiac troponin level which is 50 times the upper limit of normal has a much higher positive predictive value for the presence of an acute myocardial infarction, compared to a level just above the upper limit of normal.

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