Markers in Cardiology - AHA: Current and Future Clinical Applications / Edition 1

by Jesse E. Adams, Fred S. Apple, Allan S. Jaffe, Alan H. B Wu

Overview

Diagnostic accuracy is critical for the identification and treatment of patients with potential cardiac disease. There is now an ever-increasing reliance on the measured levels of diverse proteins (i.e. markers) whose presence in varying amounts can suggest certain cardiovascular pathologies and help to identify optimal therapeutic alternatives. Cardiac Markers: Current and Future Applications is designed to familiarize the reader with these concepts, and to facilitate the application of these concepts to patients with cardiac disease.

The chapters in this monograph detail the past, present, and potential future of markers used for the detection of myocardial injury and for risk assessment as part of a cardiovascular disease work-up strategy. The strengths of this extensive overview, written by many of the current leaders in the field, lie in the evidence presented in addressing analytical/technical, clinical, and outcome-assessments of each biomarker currently used in clinical practice, and for those being investigated as potential cutting-edge tools. Clinical cardiologists, pathologists, researchers, and critical and primary care physicians interested in the clinical application of blood-based assays in cardiac patients will all learn from this monograph.

Product Details

ISBN-13:	9780879934729
Publisher:	Wiley
Publication date:	05/18/2001
Series:	American Heart Association Monograph Series , #8
Pages:	290
Product dimensions:	6.20(w) x 9.30(h) x 0.90(d)

About the Author

Jesse E. Adams, MD, FACC, is with the University of Louisville, Division of Cardiology. He has published scientific papers in multiple journals including the New England Journal of Medicine and the Journal of the American College of Cardiology.

Fred S. Apple, PhD, is with the Department of Laboratory Medicine and Pathology at Hennepin County Medical Center. He is a professor at the University of Minnesota Department of Laboratory Medicine and Pathology. Dr. Apple also serves as an Associate Editor for the journal Clinical Chemistry.

Table of Contents

Chapter 1. Analytical Issues Affecting the Clinical Performance of Cardiac Troponin Assays - Alan H.B. Wu, PhD.

Chapter 2. Prepare To Meet Your Markers: Making the Most out of Troponin I Degradation - Jason L. McDonough, BSc(H), Ralf Labugger, MSc, and Jennifer E. Van Eyk, PhD.

Chapter 3. Functional Sensitivity of Cardiac Troponin Assays and its Implications for Risk-Stratification for Patients with Acute Coronary Syndromes - Kiang-Teck J. Yeo, PhD, Kelly S. Quinn-Hall, MT, Stephanie W. Bateman, BA, George A. Fischer, PhD, Stacey Wieczorek, PhD, and Alan H.B. Wu, PhD.

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Chapter 4. Report on a Survey of Analytical and Clinical Characteristics of Commercial Cardiac Troponin Assays - Fred S. Apple, PhD, Jesse E. Adams III, MD, Alan H.B. Wu, PhD, and Allan S. Jaffe, MD.

Chapter 5. The Current Assessment of Qualitative and Quantitative Point-of-Care Testing of Cardiac Markers - Roland Valdes, Jr, PhD and Saeed A. Jortani, PhD.

Chapter 6. Acute Coronary Syndromes: Pathophysiology, Clinical Presentation, and Initial Diagnostic Strategies - Jesse E. Adams III, MD and Vickie A. Miracle, RN, EdD.

Chapter 7. WHO Criteria: Where Do We Go from Here? - Allan S. Jaffe, MD.

Chapter 8. An Integrated Diagnostic Approach to the Patient with Chest Pain - Robert L. Jesse, MD, PhD and Michael C. Kontos, MD.

Chapter 9. The Use of Cardiac Markers for Therapeutic Decisions in Acute Coronary Syndromes - Michael P. Hudson, MD, Britta U. Goldmann, MD, E. Magnus Ohman, MD.

Chapter 10. The Evaluation of Acute Coronary Syndrome in the Emergency Department: The Impact of Cardiac Biomarkers and ST-Segment Trend Monitoring - David A. Grundy, MD and W. Brian Gibler, MD.

Chapter 11. Cardiac Troponin T in Coronary Artery Disease: Where Do We Stand? Evangelos Giannitsis, MD, Britta Weidtmann, MD, Margit Müller-Bardorff, MD, Norbert Frey, MD, and Hugo A. Katus, MD.

Chapter 12. Creatine Kinase: A Marker for the Early Diagnosis of Acute Myocardial Infarction - Robert Fromm, MD, MPH and Robert Roberts, MD.

Chapter 13. Fatty Acid Binding Protein as a Plasma Marker for the Early Assessment of Individuals with Acute Coronary Syndromes - Jan F.C. Glatz, PhD and Wim T. Hermens, PhD.

Chapter 14. Oxidized Low-Density Lipoprotein and Malondialdehyde-Modified Low-Density Lipoprotein: Markers of Coronary Artery Disease - Paul Holvoet, PhD, Frans Van de Werf, MD, PhD, Johan Vanhaecke, MD, PhD, and Désiré Collen, MD, PhD.

Chapter 15. High-Sensitivity C-Reactive Protein: A Novel Inflammatory Marker for Predicting the Risk of Coronary Artery Disease - Paul M. Ridker, MD, MPH.

Chapter 16. Nuclear Factor Kappa B: A Marker of Coronary Artery Disease Activity? - George K. Daniel, MD, Richa Gupta, MD, Jessica Gillespie, BS, Rose Felten, BS, Linda Cise, MS, Kathy Sturdevant, BS, and Michael E. Ritchie, MD.

Chapter 17. The Use of Troponins to Detect Cardiac Injury after Cardiac and Noncardiac Surgery - Jesse E. Adams III, MD.

Chapter 18. The Role of Cardiac Troponin Testing in Renal Disease - Fred S. Apple, PhD.

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Chapter 19. The Use of Cardiac Biomarkers for the Detection of Drug-Induced Myocardial Damage - Eugene H. Herman, PhD and V.J. Ferrans, MD, PhD.

Chapter 20. The Utility of Brain Natriuretic Peptides in Patients with Heart Failure and Coronary Artery Disease - Johannes Mair, MD

Editorial Reviews

Reviewer: John F. Moran, MD (Loyola University Stritch School of Medicine)
Description: This book, one in the series of the American Heart Association monographs, is a multiauthored text of 20 chapters covering current markers in coronary artery disease, unstable angina syndromes, and myocardial infarctions, as well as those markers currently under research.
Purpose: The purpose is to gather all current material on markers in ischemic heart disease in one place written by authors who are active in the research.
Audience: This is an important book for all directors of coronary care units and cardiologists.
Features: The first half of the book is devoted to a review of the use of cardiac troponins and creatinine kinase MB and myoglobins in the diagnosis of ischemic heart disease. There is good material on the problems with the use of cardiac troponins: lack of an assay standardization among a half dozen or more manufacturers; the use of troponins in renal failure and renal insufficiency; false positive elevations of troponins; and interassay imprecision; for example, the lack of validation of the low cut-off concentration for troponins. False positive analysis of troponins include heterophile antibodies, mouse antibodies, fibrin strands, and rheumatoid factors. Troponins in an acute myocardial infarction can be detectable after six hours or for up to three months. Abnormal troponins have been associated with a four- to five-fold increase in risk for myocardial infarction and death. The use of biomarkers is truly to confirm a diagnosis already made on the basis of clinical examination and electrocardiographic findings. There is a good chapter on the acute coronary syndrome with important information on C reactive protein in myocardial infarctions, P-selectin, fibrinopeptide, and fibrinopeptide A. There is also a good review on the use of myocardial perfusion images, electrocardiography, and echocardiography and their relationship to prognosis. The last eight chapters of the book are devoted to new markers currently under investigation. These include fatty acid binding proteins, oxidized LDL, high-sensitivity C-reactive protein, nuclear kappa factor B, and brain natruretic peptides.
Assessment: The differential diagnosis of acute coronary syndrome-unstable angina from acute myocardial infarction requires the demonstration of myocardial necrosis. The sooner this can be confirmed, the sooner proper treatment can be instituted. This is not only true for ischemic heart disease, but also in drug-induced myocardial damage. Many tables supplement the text. The index is helpful and each of the chapters is accompanied by many recent references, up to 132. This book is recommended for all clinicians who deal with patients with ischemic heart disease.

Doody's Review Service

4 Stars! from Doody

This 20-chapter monograph explores the use of measured levels of diverse proteins ("markers") to diagnose and treat patients with cardiac disease. Both the advantages and potential limitations in the use of markers in diagnosis and treatment are considered. A sampling of topics covered includes the evaluation of acute coronary syndromes in emergency departments; cardiac troponin T in coronary artery disease; fatty acid binding protein as an early marker of acute coronary syndrome; high-sensitivity C-reactive protein. Contributors include academic and clinical cardiologists, researchers, and emergency physicians from the U.S., Canada, and western Europe; the four editors have affiliations with the U. of Louisville, U. of Minnesota, Mayo Clinic, and Hartford Hospital (among other institutions). Annotation c. Book News, Inc., Portland, OR (booknews.com)

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