Multimarker approach in risk stratification of patients with acute coronary syndromes: Towards the ideal stratification

As with other cardiovascular diseases, advances in our understanding of the pathophysiology of acute coronary syndrome (ACS) have resulted in the use of new biomarkers (measurable plasma molecules) that reflect the different mechanisms that underlie the condition.These biomarkers are valuable tools that are increasingly used not only for early diagnosis but for short-and long-term prognostic stratification.A wide range of biomarkers are now available in ACS, including those that reflect vascular inflammation due to atherosclerotic disease (high-sensitivity C-reactive protein [CRP]), markers of protease activity associated with progression of atherosclerosis and plaque destabilization (cystatin C), and those indicating myocardial injury (troponin and ST2), renal damage (cystatin C, NGAL, glomerular filtration rate), or ventricular dysfunction (neurohormonal peptides