Use of Molecular Markers in the Diagnosis of Angina Pectoris

Abstract

Angina pectoris is chest pain or discomfort due to reduced blood flow to the heart. Angina can be stable or unstable. Most people with angina have stable angina, which can often be treated with medication and lifestyle changes. Unstable angina is more serious, has not been diagnosed as a heart problem before, or is being treated but is getting worse. In all these cases, visit to a doctor or other health provider is essential. Angina that comes on much more easily, lasts longer, or is more severe than usual is considered a medical emergency and the patient may need to seek treatment. Angina pectoris and acute coronary syndromes affect millions of people around the world annually, and an early diagnosis is crucial to provide patients with adequate therapy based on their condition. Various methods and markers for detecting this mechanism have been investigated in recent years, however, attention is still mainly focused on the serum blood markers, which have good specificity but poor sensitivity for the early diagnosis of these conditions or their risk factors [1]. Because many patients consulted a doctor due to uncertain chest pain, the cardiovascular assessment must include a detailed history and careful examination, in addition to investigating other possible causes of angina pectoris. In patients with a typical history of angina pectoris, the main non-invasive tests are exercise electrocardiography, nuclear perfusion imaging, and echocardiography. However, in some patients, the electrocardiogram may be normal between episodes of angina pectoris, and different types and power of blocking treatment may mask a positive exercise stress test. This indicates the need for more specific markers in the detection and evaluation of coronary artery stenosis, the risk of myocardial infarction in stable angina pectoris, and even in asymptomatic patients due to risk factors in young people with early or mild coronary atherosclerosis. Such a marker would allow for a better selection for invasive coronary angiography and would help avoid these procedures which are the gold standard in coronary artery disease detection because of their invasiveness and possible complications.