• 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:

                - NT-proBNP is helpful in the differential diagnosis of cardiogenic and pulmonary dyspnea.

                - NT-proBNP is helpful for risk stratification in patients with chronic heart failure.

                - For patients hospitalized for heart failure, testing of NT-proBNP at admission is helpful in assessing prognosis.

        2. Cardiac fatty acid-binding protein (H-FABP) has been included in the "Expert Consensus on the Application of Myeloperoxidase, Cardiac Fatty Acid-binding Protein and Myocardial Troponin I Combined Detection in Acute Coronary Syndrome (2018)", which is recommended for the early diagnosis of acute myocardial infarction.

        3. The combined assay of myocardial triad (Myo, cTnI, CK-MB) within 6 hours of chest pain is helpful to timely and accurately distinguish patients with myocardial infarction and create conditions for timely rescue of patients.

        4. D-dimer has been included in the laboratory recommended test items in the "Chinese Guidelines for Diagnosis and Treatment of Intracranial Venous and Sinus Thrombosis (2021 edition)".