Introduction
Definitions
What makes a good biomarker?
Biomarkers in acute myocardial infarction
Diagnostic biomarkers
C-terminal-provasopressin (Copeptin)
Heart-Type Fatty Acid Binding Protein (H-FABP)
Prognostic biomarkers
1) Biomarkers of biomechanical stress
BNP/NTproBNP
Study Pop | N | Endpoints | Thresholds | Odds ratio or Hazard Ratio | Ref |
---|---|---|---|---|---|
ACS-TIMI16 | 2,525 | Death (30 day, 10 months) HF(10 months) MI (10 months) | Quartiles BNP > 80 pg/ml | 1, 3.8, 4.0, 5.8 Approximately 2.7 Approximately 2 | [28] |
AMI | 70 | Death (18 months) | Median (>59 pg/ml) | Approximately 2.5 | [29] |
AMI-CONSENSUS | 131 | Death (one year) | 75th centile BNP 33.3 pmol/L | Approximately 1.36 | [30] |
ACS | 609 | Death | Median | 2.4 | [37] |
NSTEACS | 1,483 | Death (in hosp) (180 days) | BNP > 586 pg/ml | (1.7) (1.67) | [38] |
FRISC-II | 2,019 | Death | Top Tertile | 4.1(invasive) vs 3.5(non-invasive) | [36] |
TACTICS-TIMI18 | 1,676 | Death (six months) HF (30 days) | BNP > 80 pg/ml | OR 3.3 OR 3.9 | [35] |
ACS | 1,033 | Death (30 day) (six months) | Quartiles | (2.24) (1.84) | [34] |
AMI | 473 | Death | Median | OR 3.82 | [39] |
Mid-Regional pro-Atrial Natriuretic Peptide (MRproANP)
Growth Differentiation Factor-15(GDF-15)
Study Pop | N | Endpoints | Thresholds | Odds ratio or Hazard Ratio | Ref |
---|---|---|---|---|---|
GUSTOIV (NSTEACS) | 2,081 + 429 | Death (one year) | Tertiles < 1,200 ng/L, 1,200 to 1,800 ng/L > 1,800 ng/L | 1.5%, 5%, 14.1% | [46] |
FRISC-II (invasive vs conservative) | 2,079 | Death or MI (2 yrs) | Invasive at > 1,800 ng/L Invasive 1,200 to 1,800 ng/L Invasive < 1,200 or Trop -ve | HR 0.49 (risk reduction) HR 0.68 No benefit | [47] |
ASSENT-2/plus (STEMI) | 741 | Death (1 yr) | Tertiles < 1,200, 1,200 to 1,800, > 1,800 | 2.1%, 5.0%, 14% | [48] |
AMI | 1,142 | Death or HF (1.5 yr) | <1,470 ng/L, >1,470 ng/L | HR 1.77 | [49] |