Comprehensive Quality Analysis of Conventional and Novel Biomarkers in Diagnosing and Predicting Prognosis of Coronary Artery Disease, Acute Coronary Syndrome, and Heart Failure, a Comprehensive Literature Review
Muhammad Abubakara✉, Umema Irfanb, Ahmad Abdelkhalekc, Izzah Javedd, Muhammad Imran Khokhare, Fraz Shakilf, Saud Razag, Siffat Saima Salimh, Muhammad Mahran Altafd, R Habibi, Simra Ahmedj, Farea Ahmedj
- aDepartment of Internal Medicine, Ameer-Ud-Din Medical College, 6 Birdwood Road, Jinnah Town, Lahore, 54000, Punjab, Pakistan. Muhammadabubakar2053@hotmail.com
- bDepartment of Internal Medicine, Deccan College of Medical Sciences, Hyderabad, India
- cDepartment of Internal Medicine, Zhejiang University, Zhejiang, China
- dDepartment of Internal Medicine, Ameer-Ud-Din Medical College, 6 Birdwood Road, Jinnah Town, Lahore, 54000, Punjab, Pakistan
- eDepartment of Surgery, Gujranwala Medical College, Gujranwala, Pakistan
- fDepartment of Emergency Medicine, Mayo Hospital, Lahore, Pakistan
- gDepartment of Anesthesia, Social Security Teaching Hospital, Lahore, Punjab, Pakistan
- hDepartment of Surgery, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh
- iDepartment of Internal Medicine and Emergency, Indus Hospital, Lahore, Pakistan
- jDepartment of Internal Medicine, Ziauddin Medical College, Karachi, Pakistan
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Abstract
Coronary artery disease (CAD), acute coronary syndrome (ACS), and heart failure (HF) are major global health issues with high morbidity and mortality rates. Biomarkers like cardiac troponins (cTn) and natriuretic peptides (NPs) are crucial tools in cardiology, but numerous new biomarkers have emerged, proving increasingly valuable in CAD/ACS. These biomarkers are classified based on their mechanisms, such as fibrosis, metabolism, inflammation, and congestion. The integration of established and emerging biomarkers into clinical practice is an ongoing process, and recognizing their strengths and limitations is crucial for their accurate interpretation, incorporation into clinical settings, and improved management of CVD patients. We explored established biomarkers like cTn, NPs, and CRP, alongside newer biomarkers such as Apo-A1, IL-17E, IgA, Gal-3, sST2, GDF-15, MPO, H-FABP, Lp-PLA2, and ncRNAs; provided evidence of their utility in CAD/ACS diagnosis and prognosis; and empowered clinicians to confidently integrate these biomarkers into clinical practice based on solid evidence.