Myocardial Infarction: A Review of Laboratory Biomarkers

Abstract

Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide, necessitating rapid and accurate diagnostic and prognostic tools. Laboratory biomarkers have become indispensable in the management of acute coronary syndromes, offering a window into the dynamic pathophysiological processes of myocardial ischemia, injury, and repair. This review provides a comprehensive evaluation of the spectrum of cardiac biomarkers, from the established gold standard of high-sensitivity cardiac troponin (hs-cTn) to conventional enzymes like creatine kinase-MB (CK-MB) and myoglobin, as well as emerging novel markers. We discuss the clinical utility, diagnostic accuracy, prognostic value, and limitations of each biomarker within the context of current international guidelines. Additionally, this article explores the evolving landscape of biomarker research, including the potential of microRNAs, cardiac myosin-binding protein C (cMyC), and multimarker panels to use in an era of personalized medicine in cardiovascular care.

The future of MI biomarker utilization lies in integration. No single biomarker is likely to capture the full complexity of the disease. Multimarker panels that combine markers of myocyte necrosis (e.g., hs-cTn), hemodynamic stress (e.g., BNP/NT-proBNP), inflammation (e.g., GDF-15, hs-CRP), and fibrosis (e.g., galectin-3, sST2) are being developed to provide a comprehensive picture of a patient's risk profile and guide personalized treatment strategies