International Journal of Cardiovascular Sciences. 01/mar/2019;32(2):100-1.

Biomarkers and Mortality in ST-Segment Elevation Myocardial Infarction

Pedro Pimenta de Mello Spineti

DOI: 10.5935/2359-4802.20190013

Biomarkers have been increasingly used in non-ST-segment elevation acute coronary syndromes (NSTE-ACS) for diagnosis, stratification, and short-and long-term prognosis. However, they play a less decisive role in ST-segment elevation myocardial infarction (STEMI) where ST-segment elevation in ECG remains the most important tool for diagnosis and treatment decision.

Troponin has been the most widely used biomarker to evaluate the prognosis in STEMI, but other biomarkers may also be used to assess the potential causes and complications of myocardial infarction (MI). High sensitivity C-reactive protein (hs-CRP) is substantially increased in STEMI as a result of the inflammatory response to myocyte necrosis, and is associated with the subsequent risk for death or heart failure.^– Natriuretic peptides reflect the hemodynamic impact of MI and are associated with its prognosis. Although both natriuretic peptides and CRP enhance risk assessment, no clear guidance is available on how to direct specific therapeutic maneuvers in the setting of STEMI based on these biomarkers.

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