Researchers at Catharina Hospital in The Netherlands report in Clinical Chemistry that variations in cardiac troponin levels determined by new, highly sensitive assays can identify emergency room patients with acute myocardial necrosis. They examined short-term differences in cardiac troponin in emergency department patients using Roche Diagnostics' high-sensitivity cardiac troponin T assay and Siemens Diagnostics' sensitive cTnI assay. "The short-term variations and IIs of cardiac troponin were low in ED patients free of ischemic myocardial necrosis," they report, adding that they advise using cut-off values of 8 ng/L for the hs-TnT assay and 17 ng/L for the cTnI assay. "With the use of this approach," the team adds, "the time between arrival and appropriate management may be shortened and the strain on ED capacity decreased."

Also in Clinical Chemistry, Kai Wollert from Hannover Medical School in Germany and colleagues discuss their use of expression cloning to find a prognostic biomarker for acute coronary syndrome. The researchers developed an expression screen to look for genes that encode activators of the GDF15 promoter. GDF15 is a stress-response cytokine whose expression is linked to prognosis in acute coronary syndrome. From their screen, the researchers found that secreted protein follistatin-like 1, or FSTL1, induces GDF15 expression and is independent biomarker for ACS prognosis. "Our study is the first to use expression cloning for biomarker discovery upstream of a gene of interest, a strategy that will be applicable outside the specific example provided here," they add.