Abstract / Summary
Ischemic heart disease (IHD) is one of the major cardiovascular disorders and remains an important cause of morbidity and mortality worldwide. Early recognition of myocardial ischemia and myocardial injury is essential for initiating timely treatment and reducing the risk of irreversible cardiac damage. However, the clinical presentation of IHD may be variable, and conventional diagnostic methods may have limitations during the earliest stages of myocardial injury. Therefore, circulating biomarkers have become an important component of the early diagnostic assessment of patients with suspected ischemic heart disease. Among currently available biomarkers, high-sensitivity cardiac troponin I and cardiac troponin T are considered the principal biomarkers for detecting myocardial injury because of their high analytical sensitivity and ability to identify small changes in circulating troponin concentrations. Other biomarkers, including creatine kinase-MB, myoglobin, copeptin, natriuretic peptides, inflammatory mediators, and markers of oxidative stress, may provide complementary diagnostic and prognostic information. The integration of biomarker measurements with clinical assessment, electrocardiography, and cardiac imaging can improve diagnostic accuracy and support early risk stratification. Serial measurements of high-sensitivity cardiac troponin are particularly important because dynamic changes in its concentration may help distinguish acute myocardial injury from chronic elevation. Nevertheless, biomarker interpretation can be challenging because increased cardiac troponin concentrations may occur in various cardiovascular and systemic conditions without acute myocardial infarction. This review summarizes the biological basis, diagnostic significance, advantages, and limitations of established and emerging biomarkers in ischemic heart disease, with particular emphasis on their role in early detection and clinical decision-making. A better understanding of these biomarkers may contribute to more accurate and timely recognition of myocardial injury and improve strategies for the early assessment of patients with suspected ischemic heart disease.