Chapter 30 Biomarkers for coronary artery disease and heart failure

Cardiovascular disease (CVD) continues to be an important cause of death throughout the world. Diagnostic tests, in particular blood-based biomarkers, have played an integral role in CVD for over 60 years, especially for the diagnosis of acute myocardial infarction (AMI), where initially the enzymatic activity of serum aspartate aminotransferase was demonstrated to be increased in patients with AMI. Since the turn of the millennium, however, cardiac troponin has taken a prominent role and is considered the most optimal blood-based biomarker to be used in the diagnosis of AMI. In addition, the prevalence of heart failure (HF) in the population has increased, with projections in the United States suggesting close to a 50% increase in the HF prevalence from 2012 to 2030, resulting in more than 8 million adults living with HF. This chapter will discuss cardiovascular pathologies, in particular AMI and HF, as well as biomarkers used for detection and management of these patients including troponin, creatine kinase-MB, myoglobin, BNP, and N-terminal-proBNP, as well as others.