The spectrum of unstable coronary syndromes has been the object of steadily increasing research particularly in respect of novel diagnostic and treatment modalities. Although the WHO criteria for the diagnosis of acute myocardial infarction have been known for decades, there is still much debate as to the proper use of these, especially the handling of biochemical markers. Traditional enzymes have limitations in diagnostic power and new markers have unclarified applicability with regard to standardisation of assays and decision limits. Furthermore, the growing understanding of the conception of minimal myocardial damage in the borderzone between unstable angina pectoris and myocardial infarction necessitates refinement in the definitions of the various entities within the kaleidoscope of acute myocardial ischaemia. There has been a strong impetus within the European Society of Cardiology to present this subject to a broad audience of cardiologists, and as a consequence the theme of biochemical markers has become an important constituent of the Education and Training Programmes of the Society. This book has fundamental implications for the overall comprehension of this complex area. This book on myocardial damage, compiled by international experts, will truly appeal to the basic scientist as well as the clinician searching for updated knowledge of the pathophysiology and risk stratification of unstable coronary syndromes.

Inhalt

1. Cellular mechanisms of ischaemic myocardial damage.- 2. Creatine Kinase isoforms.- 3. Myocardial Damage: The role of Troponin T.- 4. Troponin I: structure, physiology and it's role in risk stratification of angina patients.- 5. Myoglobin.- 6. Glycogen phosphorylase isoenzyme BB.- 7. Fatty acid-binding protein as a plasma marker for the early detection of myocardial injury.- 8. Mechanisms of protein release from injured heart muscle.- 9. Prolonged chest pain and the early detection of myocardial damage by novel biochemical markers practical considerations.- 10. Prognostic value of biochemical markers in ischaemic heart disease.- 11. Troponin T in the management of ischaemic heart disease patients: a clinical cardiologist's view.- 12. New soluble markers for assessment of infarct size.- 13. Value of soluble markers in the diagnosis of reperfusion after thrombolysis.- 14. The assessment of myocardial damage in heart transplantation.- 15. Economic aspects of new biochemical markers for the detection of myocardial damage.- 16. Role of serum biochemical markers in clinical trials.- 17. Pre-clinical application of markers of myocardial damage.