The use of biomarkers for the evaluation and treatment of patients with acute coronary syndromes.

The advent of inexpensive, highly accurate, and predictive markers of myocardial injury, inflammation, and hemodynamic stability has revolutionized the evaluation and treatment of patients who have acute coronary syndromes (ACSs). These blood biomarkers require small sample volumes, can be run expeditiously, and provide important information concerning the diagnosis, risk stratification, and treatment of these patients. To understand the use of these markers, one must have some knowledge about what elevations in these markers imply, how they have to be collected and measured to provide reliable information, when to suspect analytic confounds, and what the key values are that impart the diagnostic, prognostic, and therapeutic information. This article discusses these issues, emphasizing what clinicians must know for optimal test use, and then addresses the practical use of these markers in patients who have ACS.