**Author details**

an elevated level of cTnI be identified as an amount above the 99th percentile of a normal

Conversely in patients with unstable angina and acute MI without the evidence of ST segment elevation (NSTEMI) the expectation of suffering from an adverse event is reported to be quite difficult. The advancement as well as commercialization of more specific and more sensitive cardiac troponin I (cTnI) immunoassays have considerably added to the accurate diagnosis of

The definition of MI was formally redefined in 2000 by the European Society of Cardiology and the American College of Cardiology to realign evidence of myocardial injury as defined by biomarkers with a particular advocacy on troponin [32]. The 2000/2002 American College of Cardiology (ACC) and the American Heart Association (AHA) Guideline Update evocatively advocate to incorporate the estimation of cTnI for the management of AMI patients and also for the risk stratification of patients presenting with symptoms suggestive of acute coronary syndromes [40, 91]. This definition was updated in 2007 [43] to reflect the progress that had been made in understanding assays. It again relied heavily on a definition based on troponin. Specifically, with rare exception, the diagnosis cannot be made in the absence of

Considering the potential adverse outcomes the estimation of the prognosis should aid clinicians in identification and management of high risk patients. Eventually the evaluation of the prognosis will be helpful in both the identification of site of care as well as in distinguishing

Acute myocardial infarction usually presents with discomfort or chest pain, weakness, sweating, nausea, vomiting, and arrhythmias. Common risk factors include old age, obesity, smoking, hypertension, hypercholesterolemia and diabetes mellitus. Myocardial ischemia may result either from increased demand or decreased supply of oxygen to the myocardium or

A consensus guideline from both the American College of Cardiology (ACC) and the European Society of Cardiology (ESC) has redefined AMI as a typical rise and fall of serum biochemical markers (e.g., Troponin, CK-MB), associated with symptoms of ischemic injury, new pathologic Q waves on ECG, ischemic ECG changes (ST-segment elevation or depres-

Biochemical cardiac markers include myoglobin, cardiac troponin T, cardiac troponin I, CK-MB, LDH, and many others like ischemia modified albumin, Glycogen phosphorylase BB and fatty acid binding protein. Cardiac markers are vital not only from diagnostic but also

patients most likely to get benefit from specific therapeutic interventions.

sion), coronary artery intervention or histological findings of AMI.

control group, that is, 99th percentile of the upper reference limit [89, 90].

MI and to the risk stratification of NSTEMI/UA patients.

elevated biomarkers of cardiac injury [43, 68].

**7. Conclusion**

32 Myocardial Infarction

from the prognostic viewpoint.

both.

Shazia Rashid<sup>1</sup> \*, Arif Malik2 , Rukhshan Khurshid<sup>3</sup> , Uzma Faryal<sup>4</sup> and Sumera Qazi<sup>5</sup>

\*Address all correspondence to: shazia.rashid9@gmail.com

