Clinical application of markers of cardiac injury: basic concepts and new considerations.

Cardiac markers have progressed from measurement of enzymes such as serum glutamate oxaloacetate transaminase and creatine kinase isoenzymes to structural proteins such as cardiac troponin. The utility of biomarkers have evolved from diagnosis of cardiac injury to assessment of the prognosis of patients with unstable angina. While cardiac angiography can serve as the gold standard for coronary anatomy, it is inadequate for detecting active myocardial damage. The finding of a typical rising and falling pattern of a highly specific biochemical marker in blood such as cardiac troponin will likely be the best indicator for detection of myocardial cell necrosis.