Navigating Acute Coronary Syndrome
Cardiovascular diseases (CVDs) remain a leading cause of death worldwide, accounting for nearly 19.8 million deaths annually, representing approximately one-third (32%) of all global deaths.1
Acute coronary syndrome (ACS), which includes myocardial infarction (heart attack) and unstable angina (UA), is among the most serious manifestations of ischemic heart disease, the leading cause of cardiovascular death worldwide.2 ACS contributes substantially to global morbidity, mortality, and healthcare burden.
While substantial progress has been made in high-income countries, the burden of ACS remains disproportionately high in low and middle income regions, where mortality rates continue to be among the highest in the world.
ACS refers to a spectrum of conditions caused by a sudden reduction or interruption of blood flow to the heart muscle due to narrowing or blockage of a coronary artery. ACS includes:
- ST-elevation myocardial infarction (STEMI)
- Non-ST-elevation myocardial infarction (NSTEMI)
- Unstable angina (UA)
5th universal definition of Myocardial Infarction3:
“Myocardial infarction is defined pathologically as myocardial cell death due to prolonged periods of ischemia caused by insufficient or absent coronary blood flow and reperfusion injury.”
The clinical diagnosis of myocardial infarction requires evidence of acute myocardial injury alongside other signs, symptoms and evidence from electrocardiogram (ECG) and imaging. Acute myocardial injury is defined as a rise and/or fall in cardiac troponin with at least one value above the sex-specific 99th percentile URL.
Learn how high-sensitivity cardiac troponin is helping drive faster, more informed clinical decision-making in emergency and cardiovascular medicine
Acute Myocardial Infarction (AMI) is a medical emergency requiring immediate evaluation and intervention. Delays in diagnosis and treatment can result in irreversible myocardial damage, heart failure, recurrent cardiovascular events, or death.
Rapid recognition, timely reperfusion, and comprehensive secondary prevention are essential to improve patient outcomes.
Chest pain or discomfort is the most common symptom of ACS, however 33% of patients may not experience chest pain.4
Beyond the initial event, AMI is associated with high mortality, recurrent cardiovascular complications, frequent hospital readmissions, reduced quality of life, and increased healthcare costs.
Accurate diagnosis of AMI requires the integration of clinical assessment, electrocardiography, and cardiac biomarker testing.
Current international guidelines recommend a 3-pillar approach for suspected AMI5:
1- Clinical evaluation: assessment of symptoms, medical history, cardiovascular risk factors, and physical examination findings.
2- Electrocardiogram (ECG): An ECG should be performed within 10 minutes of presentation in patients with suspected ACS to identify ST-segment changes and other signs of ischemia.
3- Cardiac biomarker testing: Cardiac troponins are the preferred biomarkers for detecting myocardial injury. High-sensitivity cardiac troponin (hs-cTn) assays allow clinicians to:
- Detect myocardial injury earlier;
- Rule out myocardial infarction safely;
- Identify high-risk patients;
- Support evidence-based clinical decision-making.
Patients presenting with chest pain represent one of the most common reasons for emergency department visits. However, only a minority of these patients are ultimately diagnosed with AMI.
Because symptoms and ECG findings alone may be insufficient to confirm or exclude myocardial infarction, high-sensitivity cardiac troponin testing plays a critical role by providing objective biochemical evidence of myocardial injury.
Used alongside clinical assessment and ECG findings, hs-cTn supports:
- Earlier diagnosis;
- Efficient patient triage;
- Rapid identification of patients requiring urgent intervention;
- Safe discharge of low-risk patients;
- Reduced unnecessary admissions.
While central laboratory testing remains an essential component of AMI pathways, delays associated with specimen transport and laboratory turnaround times may impact clinical workflows and patient throughput.
High-sensitivity cardiac troponin testing at the point-of-care has the potential to:
- Accelerate clinical decision-making;
- Reduce diagnostic delays;
- Improve patient flow;
- Facilitate care in facilities without an onsite laboratory.
SPINCHIP® hs-cTnI is a point-of-care immunoassay platform designed to deliver quantitative high-sensitivity cardiac troponin I (hs-cTnI) results directly at the point-of-care.
Educational Resources
Access educational resources focused on Acute Coronary Syndrome diagnosis, high-sensitivity cardiac troponin testing, and point-of-care innovation.
Disclaimer:
The content on this website and associated materials do not constitute medical advice and should not be considered a substitute for the individual professional judgement of any physician or other health care practitioner regarding the appropriate course of action for a particular patient. All recommendations should be independently reviewed with appropriate medical staff in light of the needs of any particular institution and its patients. bioMérieux makes no guarantee or representation regarding the accuracy, completeness, or usefulness of this information for any particular purpose, including but not limited to any cost savings.
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