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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.
Synopsis
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.
Doody Review Services
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.
Editorials
From The Critics
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.
Booknews
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)4 Stars! from Doody