An ESC/ACC consensus conference in 1999 defined cTnI and cTnT as the cornerstone biomarkers for diagnosis of AMI. If cardiac troponins are not available, then CK-MB should be used as a substitution marker.
In 2007, the ESC/ACC/AHA published new criteria for an AMI:
Elevated biomarkers and one of the following:
- Ischemic symptoms
- ECG changes indicating a new ischemic event
- Pathological ECG with Q waves (abnormal tracings found in AMI)
- Imaging evidence of new myocardial damage
In 2002, ACC/AHA published practice guidelines for diagnosis of new category of heart disease, ACS. AACC and IFCC continue to improve guidelines in order to improve and clarify diagnosis. The goal is to increase detection of those presenting with an AMI (true positive) and decrease hospitalization of those who present with chest pain and have not experienced an AMI (false positive).
