Cardiac Biomarker Detection: From Epidemiology to Clinical Applications in Heart Disease

Prevalence of Heart Diseases

Globally, approximately 17.5 million people die from heart disease and related conditions each year, accounting for 30% of all deaths. Although over 20 million people survive heart attacks or strokes annually, most of these patients still face a high risk of recurrence and mortality. In developed countries, due to active prevention and intervention strategies for cardiovascular diseases, the incidence and mortality rates of heart disease are significantly lower than in other regions.

In China, approximately 2.6 million people die from cardiovascular and cerebrovascular diseases each year, ranking second globally. The high incidence of heart disease has become a significant public health issue; however, fewer than 120,000 patients receive bypass surgery or interventional treatment annually. Notably, about 80% of sudden cardiac deaths are caused by coronary heart disease and its complications, while the remaining cases can be attributed to heart failure, valvular heart disease, congenital heart disease, etc. A survey of the Chinese population showed that among respondents who paid high attention to heart health (98%), 63% had been diagnosed with at least one condition affecting cardiovascular health, including heart disease (21%), obesity (17%), and stroke (7%). Only 29% of respondents were confident that they did not suffer from any of the mentioned diseases, reflecting the generally concerning state of cardiovascular health among Chinese residents.

Influencing Factors of Heart Diseases

Risk factors for heart disease can be mainly divided into two categories. One category consists of modifiable factors closely related to personal lifestyle:

1. Environmental factors: including natural environments such as air pollution and extreme temperatures, as well as social competitive pressures caused by poverty;
2. Personal factors: such as physical diseases like hypertension, hyperlipidemia, and sleep apnea syndrome, as well as psychological states like sleep disorders, mental stress, and chronic pressure;
3. Exercise factors: including lack of exercise, overweight or obesity, as well as problems like myocardial hypertrophy caused by excessive exercise;
4. Lifestyle habits: mainly including unhealthy diet and smoking behavior.

The other category includes non-modifiable factors such as age, gender, ethnicity, and family history. In addition, certain systemic diseases are also closely associated with the development of cardiovascular diseases, such as infectious diseases, respiratory diseases, digestive diseases, endocrine diseases, and platelet dysfunction.

It is evident that unhealthy lifestyle habits are one of the important reasons for increased cardiovascular disease risk, indicating that heart disease is largely preventable and controllable. By improving modifiable risk factors and conducting regular heart-related examinations, the risk of developing heart disease can be effectively reduced.

Cardiac Disease-related markers

Cardiac markers are biochemical indicators used to assess the status of heart diseases, and they have important value in the early diagnosis, risk stratification, and prognosis evaluation of myocardial injury (especially acute myocardial infarction). Currently, commonly used clinical markers include troponin (cTnI/cTnT), creatine kinase isoenzyme (CK-MB), myoglobin (Myo), D-Dimer, and N-terminal pro-brain natriuretic peptide/brain natriuretic peptide (NT-proBNP/BNP). Through single or combined detection of the above markers, it can assist in judging different development stages of heart disease and the presence of reinfarction.

1. Myocardial injury markers: Cardiac troponin, creatine kinase isoenzyme MB, and myoglobin are widely used clinical indicators of myocardial injury.
2. Cardiac markers: B-type natriuretic peptide (BNP) and NT-proBNP have important clinical significance for the early diagnosis, prognosis evaluation of heart failure, and differential diagnosis of acute chest pain.
3. Coagulation function markers: An elevated plasma D-dimer level indicates activation of the coagulation and fibrinolytic systems. It serves as a marker for hypercoagulable state and enhanced fibrinolysis in the body, acting as the preferred screening indicator for the diagnosis of acute pulmonary embolism (APE) and also used for screening and exclusion of aortic dissection. Elevated plasma D-Dimer levels indicate activation of the coagulation and fibrinolytic systems, serving as a marker of hypercoagulable state and fibrinolytic in the body. It is the preferred screening indicator for the diagnosis of acute pulmonary embolism (APE) and is also used for screening and exclusion of aortic dissection.