ABSTRACT
Following severe ischemic injury, myocytes become necrotic and lose membrane integrity. Intracellular macromolecules then diffuse into the cardiac interstitium and ultimately into the lymphatics and microvasculature (1). Depending on several factors, they eventually become detectible in the peripheral circulation. These markers of myocardial damage should be specific for cardiac tissue and absent from the periphery (2,3) to ensure a high level of diagnostic accuracy. For optimal sensitivity, they should be rapidly released into the blood in direct proportion to the degree of myocardial injury. The ideal markers should persist long enough to allow for a convenient diagnostic time frame and fall rapidly enough not to mask reinjury. Finally, they should be easily, inexpensively, and rapidly assayed. At present, no single biochemical cardiac marker satisfies all of these requirements. When clinically integrated, however, each one can provide potentially valuable diagnostic and prognostic information in the management of ACS.
