Temporal profile of protein release in myocardial infarction

Acute myocardial infarction (AMI) is one of the most important cardiovascular diseases in developed countries, where it represents the major cause of death and disability. The diagnosis of ‘‘classic’’ AMI is based on the triad of typical symptoms and changes in the electrocardiogram and in biomarkers. Biomarkers are proteins that are released into the circulation by the damaged myocardial cells. The rate of appearance of these proteins depends on several factors, mainly the rate of their elimination from the blood. Each protein has a specific time course of release in terms of first detection in the blood at concentrations above the upper reference limit, peak plasma concentration, and normalization. Blood sample for determination of biomarker changes should be taken at the time when the patient presents and later during the course of the disease, according to the kinetics of each marker. Currently, cardiac troponins and creatine kinase MB mass are the biomarkers most used for the diagnosis of AMI. Emerging markers include C-reactive protein, pentraxin-3, and brain natriuretic peptide. Heart Metab. 2009;43:31–35.