The clinical utility of cardiac markers

Cardiac markers are in the news. For almost 30 years, the clinical laborato ry has contributed to the diagnosis of myocardial infarction by measuring t he creatine kinase isoenzyme, CK-MB. The emergence of more specific cardiac markers has caused reconsideration of this strategy. A growing body of lit erature supports the diagnostic usefulness of the cardiac troponins, not on ly to diagnose acute myocardial infarction, but also to provide reliable in formation about the likelihood of an impending infarction. A draft guidelin e recommends the troponins as the new benchmark. Furthermore, new biochemic al markers may be prognostic of ischemia or serve as therapeutic markers fo r preventive procedures, such as angioplasty. These new elements will incre ase the laboratory's ability to provide improved diagnostic information.