Rationale for the early clinical application of markers of ischemia in patients with suspected acute coronary syndromes

Mandates for more rapid treatment of patients with acute myocardial infarction (AMI) are driving public education initiatives aimed at having patients present earlier in the course of their symptoms. This will make it less likely that markers of necrosis will provide the level of diagnostic sensitivity needed. In fact, the goal is to identify and treat these patients sooner in order to prevent necrosis from occurring. Given the limitations of the standard 12-lead ECG to detect ischemia, other technologies are being evaluated: the value of echocardiography and technetium-based myocardial perfusion imaging have been proven. However, the goal is to develop a simple, rapid-turn-around biochemical marker that can provide this same function, and clear progress is being made toward this end.