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Cardiac markers

What is a Cardiac Marker?

Cardiac markers are used in the diagnosis and risk stratification of patients with chest pain and suspected acute coronary syndrome (ACS).

When the heart is damaged or stressed then substances are released into the blood. These are sometimes referred to as cardiac biomarkers. It is the measurement of these biomarkers that is used to help diagnose and monitor people with suspected ACS.

The actual symptoms of ACS can vary greatly but can include chest pain, pressure, nausea and shortness of breath. But these symptoms can also occur in other non-heart related conditions. Measuring the increases in these biomarkers can help to identify people with ACS allowing a rapid diagnosis and treatment of their condition.

It is important that we are able to distinguish heart attacks from angina, heart failure, or other conditions that may have similar signs and symptoms because the treatments and monitoring requirements are different.

For example heart attacks, need prompt medical intervention is crucial to minimise further damage and future complications. Therefore cardiac biomarker tests must be available to the doctor 24 hours a day, 7 days a week with a rapid turn-around-time.

Once a patient is diagnosed then serial testing of one or more cardiac biomarkers is necessary to ensure that a rise in blood levels is not missed and to estimate the severity of a heart attack.

At present only a handful of cardiac biomarker tests are routinely used by doctors with the main test of choice for detecting heart damage being Troponin. The other biomarkers being less specific for the heart and may be elevated in skeletal muscle injury, liver disease, or kidney disease.

The table below shows certain biomarkers that are used to help diagnose, evaluate, and monitor people suspected of having Acute Coronary Syndrome (ACS).



Tissue Source

Function in disease.

Cardiac Troponin

Consists of 2 cardiac specific isoforms: T and I


Increasing levels indicate injury to heart and can remain elevated for up to 7 to 14 days after attack. This enables physicians to be able to diagnose heart attack and assist in management of treatment.


Heart-related isoenzymes of CK

Heart, brain, and skeletal muscle

Increased levels are indicative to injury to skeletal muscle or heart cells. Levels peak at around 12 to 20 hours after attack. Less specific than Troponin.


Oxygen-storing protein

Heart and other muscle cells

Increased levels are indicative to injury to skeletal muscle or heart cells. I sometimes performed with Troponin to provide early diagnosis of heart attack.

Are you developing an assay to detect heart damage?

BBI can help.

We offer a diverse range of markers that are ideal for numerous applications including life science research, immunodiagnostic platform assays, ELISA’s, lateral flow, and quality assurance control manufacture.

See the table below for details on our flagship products in the cardiac marker area.



Beta-2 Glycoprotein 1 Beta 2 Glycoprotein 1, sometimes referred to as apolipoprotein H, is a protein of 50 kDa and pI of 5.6-6.4. It is a constituent of chylomicrons, very low density lipoprotein (VLDL) and low density lipoprotein (LDL). B2GP1 is a major phospholipid binding protein. It is an important component which is measured in the assessment of anti-phospholipid syndrome. It is also more specific than anti-cardiolipin antibodies and its presence correlates better with thrombotic risk.
Creatine Kinase (CK-MB and CK-MM) Creatine kinases are found in muscle tissues and are released into the bloodstream following muscle damage. Creatine Kinase consists of 2 subunits; M and B.Combinations of the two subunits results in the isomers CK-MB, CK-MM and CK-BB. Measurement of the CK-MB isoenzyme, found in cardiac muscle, is routinely used as a marker for myocardial infarction (MI).
Troponin Complex The Troponin complex contains three subunits, I, T and C, of approximately 100 kDa each. Cardiac specific Troponin I and Troponin T have been shown as better indicators of Myocardial Infarction than CK-MB. In conjunction with ECG, Troponin measurement has a very high diagnostic efficiency. Extract grade Troponin is an excellent source for controls.
Myoglobin Myoglobin is a small haeme-containing protein of 17.5KDa that imparts the red colour to meat and is the primary oxygen-carrying protein of muscle tissues. Myoglobin is released from recently injured myocardial cells within a few hours of Infarction.
Myeloperoxidase Myeloperoxidase is an abundant leukocyte enzyme which is raised in plasma in inflammatory and cardiac conditions. Raised levels are a predictive marker for myocardial infarction which appear to be more reliable as a predictor than Troponin, CRP or CKMB levels.

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