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Biomarkers in acute coronary syndromes and their role in diabetic patients
Diabetic patients with acute coronary syndromes
are at high risk for cardiovascular complications
but risk stratification in these patients remains
challenging. Regularly, diabetic patients have a less typical
clinical presentation, which could lead to delayed
diagnosis and subsequent delayed initiation of treatment.
Since diabetic patients derive particular benefit
from aggressive anti-platelet therapy, early diagnostic
and therapeutic risk stratification of these patients is of
critical importance to improve their adverse outcome.
Although the electrocardiogram remains a pivotal
diagnostic tool in the evaluation of patients suspected of
having an acute coronary syndrome, only significant STsegment
changes provide reasonable prognostic information.
Therefore, repeated assessment of circulating
protein biomarkers represents a valuable diagnostic tool
for improving efficacy and safety of decision-making in
these patients. The combined use of biomarkers reflecting
distinct pathophysiological aspects, such as myocardial
necrosis, vascular inflammation, oxidative stress
and neurohumoral activation, may significantly improve
triage of patients with chest pain. These tools may identify
those patients that are at particularly high risk for
short-term and/or long-term cardiovascular events.
Eventually, tailored medical and interventional treatment
of diabetic patients should help to prevent these cardiac
events in a cost-effective manner.
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By Ludwig-Maximilians-Universität MünchenDiabetic patients with acute coronary syndromes
are at high risk for cardiovascular complications
but risk stratification in these patients remains
challenging. Regularly, diabetic patients have a less typical
clinical presentation, which could lead to delayed
diagnosis and subsequent delayed initiation of treatment.
Since diabetic patients derive particular benefit
from aggressive anti-platelet therapy, early diagnostic
and therapeutic risk stratification of these patients is of
critical importance to improve their adverse outcome.
Although the electrocardiogram remains a pivotal
diagnostic tool in the evaluation of patients suspected of
having an acute coronary syndrome, only significant STsegment
changes provide reasonable prognostic information.
Therefore, repeated assessment of circulating
protein biomarkers represents a valuable diagnostic tool
for improving efficacy and safety of decision-making in
these patients. The combined use of biomarkers reflecting
distinct pathophysiological aspects, such as myocardial
necrosis, vascular inflammation, oxidative stress
and neurohumoral activation, may significantly improve
triage of patients with chest pain. These tools may identify
those patients that are at particularly high risk for
short-term and/or long-term cardiovascular events.
Eventually, tailored medical and interventional treatment
of diabetic patients should help to prevent these cardiac
events in a cost-effective manner.
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