TY - CHAP M1 - Book, Section TI - Biomarkers in Decision Making A1 - Manasia, Anthony A1 - Narimasu, Jon A2 - Oropello, John M. A2 - Pastores, Stephen M. A2 - Kvetan, Vladimir Y1 - 1 N1 - T2 - Critical Care AB - KEY POINTSAn ideal biomarker has a high sensitivity and allows for clinical applications in the diagnosis, staging, prognosis, and treatment of disease.Early identification of ischemia after the rupture or erosion of an atherosclerotic coronary plaque and before myonecrosis occurs is currently under investigation. Biomarkers of myocardial ischemia include choline, a chemical released during membrane damage; unbound free fatty acids, a chemical released by ischemic myocytes and ischemia-modified albumin.The cardiac biomarkers B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are elevated in 80% of patients who present to the emergency department (ED) with chronic heart failure (CHF).Neutrophil gelatinase-associated lipocalin (NGAL) is a novel serum biomarker that can identify acute kidney injury (AKI) early after the initial renal insult and can be reliably measured in the plasma by point-of-care immunoassay. NGAL levels were elevated up to 48 hours prior to the diagnosis of AKI based on the risk or renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease (RIFLE) criteria in a recent study.The use of procalcitonin (PCT) in the diagnosis and discrimination of bacterial infection, sepsis, and response to antibiotic therapy from noninfectious causes of systemic inflammatory response syndrome (SIRS) (ie, pancreatitis) is currently in use by some institutions. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1136412810 ER -