[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-449828-105":59,"doc-detail-449828-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","early-biomarkers-of-acute-coronary-syndrome-multimarker-strategies-and-key-biomarkers","Early Biomarkers of Acute Coronary Syndrome - Multimarker Strategies and Key Biomarkers","","Early diagnosis of acute coronary syndrome (ACS) across unstable angina, non-ST elevation myocardial infarction, and ST elevation myocardial infarction is crucial in emergency care. Current guidelines emphasize cardiac troponins as the most important biomarker, with high-sensitivity assays enabling earlier detection. Additional emerging markers include H-FABP, copeptin, pregnancy-associated plasma protein A, MPO, hsCRP, and circulating microRNAs such as miRNA-21, supporting a multimarker approach for improved risk stratification. Biomarker roles also extend beyond diagnosis to prognosis, monitoring, and therapy guidance, including the modifiable potential of vitamin D deficiency.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/early-biomarkers-of-acute-coronary-syndrome-multimarker-strategies-and-key-biomarkers/449828/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/early-biomarkers-of-acute-coronary-syndrome-multimarker-strategies-and-key-biomarkers/449828.png","ImageObject",300,407,{"name":92,"@type":93},"CatatanPagi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-06","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is early diagnosis and classification of ACS important in emergency settings?","Question",{"text":112,"@type":113},"Early diagnosis and classification support proper patient management in the emergency setting by identifying ACS severity and guiding timely interventions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which biomarkers are highlighted as key early indicators for ACS?",{"text":117,"@type":113},"Cardiac troponins are emphasized as the most important biomarker. Emerging candidates include H-FABP, copeptin, MPO, hsCRP, and circulating microRNAs such as miRNA-21.",{"name":119,"@type":110,"acceptedAnswer":120},"How do high-sensitivity troponin assays improve ACS detection?",{"text":121,"@type":113},"High-sensitivity assays detect troponin concentrations at 10- to 100-fold lower levels than conventional assays, enabling earlier and more precise identification of myocardial injury soon after symptom onset.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},449828,1790764541,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39},962090894170,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Editorial  \nEarly Biomarkers of Acute Coronary Syndrome  \nAcute Coronary Syndrome  \nAcute Coronary Syndrome (ACS) includes three related clinical conditions existing along a continuum of severity: unstable angina, non‑ST segment elevation myocardial infarction, and ST segment elevation myocardial infarction. Early diagnosis and classification of ACS is important in an emergency setting for proper patient management. According to the latest guidelines of the American College of Cardiology, cardiac troponins are considered the most important biomarker of the condition after clinical history and electrocardiogram (ECG) .[1]  \nEmerging Biomarkers in Acute Coronary Syndrome  \nThe pursuit of early and reliable biomarkers for ACS has led to the identification of several promising candidates alongside troponins. Among these, heart‑type fatty acid‑binding protein (H‑FABP), copeptin, pregnancy‑associated plasma protein A, myeloperoxidase (MPO), and high‑sensitivity C‑reactive protein (hsCRP) have shown potential in providing additional prognostic and diagnostic information. These markers reflect diverse pathophysiological processes, including myocardial injury, oxidative stress, hemodynamic stress, and vascular inflammation, thereby enriching the clinician’s toolkit for the timely identification of at‑risk populations and management of ACS patients.[2,3]  \nMore recently, circulating microRNAs (miRNAs) have emerged as a novel class of biomarkers with early molecular predictive power. Certain miRNAs are released rapidly into circulation during ischemic injury and may precede detectable rises in troponin levels, thereby enhancing early ACS detection. In particular, miRNA‑21 has been identified as a key differentiating biomarker between ACS and non‑ACS cases, offering the promise of earlier diagnosis and refined risk stratification.[4] These advances underscore the transition from reliance on a single biomarker toward a multimarker strategy, integrating both traditional and emerging indicators to improve patient outcomes.  \nTroponins as the Cornerstone Biomarker in Acute Coronary Syndrome  \nThe troponin complex is an intracytoplasmic regulatory protein critical for the contraction and relaxation of striated muscle. It is composed of three subunits – troponin C, I, and T, which together mediate the interaction between calcium, actin, and myosin filaments. Troponin C is expressed in both skeletal and cardiac muscle, whereas the cardiac‑specific isoforms of troponin T and troponin I are  \nsynthesized exclusively in cardiomyocytes, making them highly specific markers of myocardial damage.[5]  \nFollowing myocardial cell death, serum troponin levels typically begin to rise within 4 h of injury. Troponin I remains detectable for approximately 4–7 days, whereastroponin T can persist for 10–14 days, allowing for both early diagnosis and delayed detection of myocardial infarction. The introduction of high‑sensitivity cardiac troponin assays has revolutionized ACS diagnostics. These assays can detect circulating troponin concentrations at levels 10‑ to 100‑fold lower than conventional assays, enabling earlier and more precise identification of myocardial injury, particularly within the first few hours of symptom onset.[6]  \nDespite significant advances in troponin estimation, novel biomarkers such as H‑FABP and copeptin, which rise earlier than troponins, may enhance early diagnosis when used in combination with it. These markers are particularly valuable in patients with inconclusive ECG findings or those presenting very soon after symptom onset, as they help exclude ACS with a high negative predictive value. H‑FABP is of particular interest in this context; however, lack of specificity limits its usefulness as a standalone diagnostic marker.[7] Similarly, copeptin has emerged asan independent marker of total mortality and morbidity inpatients with ACS, especially in those with multiple risk factors.[8]  \nIn several studies, the role of miRNAs has al","cbCailLFqQvCYbnq","https://ap.wps.com/l/cbCailLFqQvCYbnq","pdf",450553,"English","# Early Biomarkers in Acute Coronary Syndrome\n## Emerging Biomarkers and Multimarker Strategy\n## Troponins as the Cornerstone Biomarker\n## Expanded Role Beyond Diagnosis\n## Vitamin D as a Modifiable Biomarker","[{\"question\":\"Why is early diagnosis and classification of ACS important in emergency settings?\",\"answer\":\"Early diagnosis and classification support proper patient management in the emergency setting by identifying ACS severity and guiding timely interventions.\"},{\"question\":\"Which biomarkers are highlighted as key early indicators for ACS?\",\"answer\":\"Cardiac troponins are emphasized as the most important biomarker. Emerging candidates include H-FABP, copeptin, MPO, hsCRP, and circulating microRNAs such as miRNA-21.\"},{\"question\":\"How do high-sensitivity troponin assays improve ACS detection?\",\"answer\":\"High-sensitivity assays detect troponin concentrations at 10- to 100-fold lower levels than conventional assays, enabling earlier and more precise identification of myocardial injury soon after symptom onset.\"}]","Early Biomarkers of Acute Coronary Syndrome - Multimarker Strategies and Key Biomarkers | PDF",1790731173]