Essential cardiac biomarkers in myocardial infarction and heart failure

With the discovery of novel biomarkers in cardiovascular diseases, over the past decades considerable improvements in diagnosis, risk stratification and patient care could be achieved; however, despite extensive research, only few biomarkers have met the requirements of significantly improving diagnostic or prognostic approaches. Among the most established markers are cardiac troponins and natriuretic peptides, which are recommended in current guidelines for myocardial infarction or heart failure and are routinely used in clinical practice. Cardiac troponins T and I are the preferred biomarkers of choice for definition of myocardial infarction and proved to be prognostically relevant not only in acute coronary syndrome but also in non-cardiac diseases. The natriuretic peptides B-type natriuretic peptide (BNP) and amino-terminal pro-B-type natriuretic peptide (NT-proBNP) aid in diagnosis, risk stratification and monitoring of heart failure. In recent years several new promising markers have been proposed which might add incremental clinical information, most notably copeptin and growth differentiation factor (GDF) 15; however, larger studies are still required before recommendations for routine clinical use can be made.