Abstract
Current laboratory diagonosis of myocardial necrosis due to myocardial infarction or any other cause is based primarily on examination of myocardial troponins. Moreover, their plasma concentrations are now the cornerstone of myocardial infarction diagnosis.
They became earlier and earlier marker with increasing sensitivity. The negative predictive value is virtually 100%.
However, elevated levels of troponins are not exclusively caused by myocardial infarction. New problem is an interpretation of frequent mild elevations in healthy or seemingly healthy persons.
An effort to use routinely other early markers of myocardial necrosis has taken a back seat. The necessary experience in use of troponins and some other cardiomarkers has been gained only in the last few years, during which they were routinely used in clinical practice.
This article summarises practical guidance on how to use the newer, as well as the older markers and suggests how to interpret laboratory findings in relation to the Universal definition of myocradial infarction of 2012.