Recently, the general idea of the acute coronary syndrome(ACS) that includes acute myocardial infarction and unstable angina has been established. ACC/AHA guidelines in 1996 and 1999 had emphasized the importance of the initial diagnosis and the early treatment in acute myocardial infarction. We presented about the recent advances in "injured myocardial marker" around the ACS in this paper.
The sensitivity and specificity for detecting myocardial injury by troponin T and I(TnT and TnI) were superior compared with those in creatinine kinase(CK) and CK-MB. Easy rapid detection system by using whole blood was useful in the diagnosis a high risk cases in ACS. Measurement of TnT and TnI are recommended the use in the emergency room.
A guideline for a diagnosis of acute myocardial infarction had a revision(ACC/ESC) on 2000. Biochemical markers of TnT & TnI were recommended as the first step for defining the myocardial injury. Unstable angina pectoris with a minimal myocardial injury(rise in CK under two times) was defined acute myocardial infarction. As for the measurement of the myocardial injury, rapid detection and accuracy & specificity may enhance the value of modality. In future, inflammation marker such as the high sensitivity CRP and an activated platelet may be thought to become important.