Biomarkers of Necrosis for Risk Assessment and Management of ST-Elevation Myocardial Infarction
The diagnosis and immediate initiation of reperfusion therapy in patients with acute ST-elevation myocardial infarction (STEMI) are based on results of the standard 12-lead electrocardiogram. Because the appearance of cardiac markers of myocardial injury in the blood is delayed relative to the onset of symptom, cardiac markers are neither helpful for early diagnosis nor should their results be awaited before initiation of reperfusion therapy. Nevertheless, there are four important reasons to measure cardiac markers of necrosis in patients with STEMI: (1) confirmation of diagnosis, (2) monitoring of efficiency of reperfusion, (3) assessment of risk, and (4) infarct sizing.
Key WordsTroponin myocardial infarction prognosis diagnosis
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