• Cardiac Troponin (cTn) is a specific marker of myocardial cell injury, and its clinical application has fundamentally changed the pattern of diagnosis, prognosis, treatment and risk stratification of acute coronary syndrome (ACS).Its diagnosis for acute myocardial infarction (AMI) is classified as a Class A recommendation by relevant international guidelines. Based on this, the Chinese Medical Journal published the "Chinese Expert Consensus on Myocardial troponin Laboratory Detection and Clinical Application" in 2021, recommended:

        1. cTn is the preferred marker for the diagnosis and differential diagnosis of AMI (Table 1); AMI can be diagnosed if cTn is higher than 99thURL with a variation of more than 20%, and there is any evidence of clinical ischemia. If cTn continues to rise, and the increase change is less than 20%, and there is no manifestation and evidence of myocardial ischemia, it may be chronic myocardial injury.

        2. cTn can also be used to stratify cardiovascular risk in the general population and predict cardiovascular events.

• N-terminal B-type natriuretic peptide precursor (NT-proBNP) is a biomarker reflecting cardiac function, and is also the preferred biomarker for the diagnosis and differential diagnosis of heart failure, severity of disease and prognosis assessment.

        1. The 2022 AHA/ACC/HFSA Heart Failure Management Guidelines recommend BNP and NT-proBNP testing for the following applications:

                - For patients with dyspnea, BNP/NT-proBNP testing is helpful for the diagnosis or exclusion of heart failure.

                - For patients with chronic heart failure, recommended to test BNP/NT-proBNP and stratify the risk according to its level.

                - For patients hospitalized for heart failure, recommended to test BNP/NT-proBNP  upon admission for assessment of  prognosis.

        2. The Chinese Guidelines for the Diagnosis and Treatment of Intracranial Venous and Sinus Thrombosis (2021 version), released in 2021, recommended D-dimer can be an important marker for thrombosis and diagnosis and treatment laboratories.

        3. Expert consensus on joint detection of cardiovascular markers for emergency chest pain, cTn, D-dimer, and BNP/NT-proBNP markers are recommended for the first visit of patients with acute chest pain or dyspnea in the ER for the purpose of differentiation and diagnosis, risk stratification, prognosis assessment and treatment decision.