Myocardial Damage

The early detection of myocardial damage is one of the major challenges in contemporary cardiology. New biochemical markers have now emerged which appear to be highly sensitive and specific for the assessment not only of patients with myocardial infarction but also of those with unstable angina and prolonged chest pains. Some of these markers, such as the troponins, have been shown to have prognostic value in the context of acute chest pain. The incorporation of novel markers of myocardial damage to the routine diagnostic armamentarium is not without difficulty. The reasons for this include cost-benefit implications and the lack of definitive comprehensive publications dealing specifically with these issues. Technical difficulties with some of the novel markers are also a problem in some cases and this issue also needs to be carefully reviewed. A critical analysis of the biochemical characteristics, sensitivity and specificity as well as the potential clinical applications of the new markers is required. This monograph addresses these issues and also sets up the basis for a redefinition of myocardial damage and myocardial infarction. The book will be of particular interest to biochemists, pharmacologists, cardiologists, general physicians and clinical and basic researchers. The important issue of myocardial damage in relation to pharmacological agents has been specifically addressed in the book and this topic will be of particular interest to both clinical pharmacologists and those working in the pharmaceutical industry. International authorities, whose original work and expertise in the field are widely recognised, have contributed chapters to the book.