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(Chest. 2002;122:1428-1435.)
© 2002 American College of Chest Physicians

Acute Coronary Syndrome*

Biochemical Strategies in the Troponin Era

Mauro Panteghini, MD

* From the Laboratorio Analisi Chimico Cliniche 1, Azienda Ospedaliera ‘Spedali Cvili,’ Brescia, Italy.

Correspondence to: Mauro Panteghini, MD, Laboratorio Analisi Chimico Cliniche 1, Azienda Ospedaliera ’Spedali Civili’, 25125 Brescia, Italy; e-mail: panteghi{at}bshosp.osp.unibs.it

New biomarkers, such as cardiac troponins, have a major role to play for cost-effective management of individuals with acute chest pain and suspected coronary syndrome, and the laboratory is now poised to assume a vital role in assessing damage and determining prognosis. The redefined biochemical criterion proposed to classify acute coronary syndrome patients presenting with ischemic symptoms as patients with myocardial infarction is heavily predicated on an increased troponin concentration in blood. In an era of evidence-based medicine, we can no longer overlook the diagnostic and prognostic benefits provided by the measurement of these highly sensitive and specific proteins.

Key Words: emergency medicine • laboratory diagnosis • myocardial infarction • myoglobin • troponin




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