Introduction

Extract

There is no area of laboratory medicine that requires more interpretive knowledge than cardiovascular risk assessment. The clinical laboratory has moved far from the days when triglycerides, total cholesterol, HDL and a calculated LDL were the only laboratory tests that could be used to assess the cardiovascular risk for patients. In this series we will look at four different topics in cardiovascular laboratory medicine.

One can think of cardiovascular laboratory medicine as having two arms; tests used to assess cardiovascular risk, and tests used to assess myocardial infarct. Of course these two arms overlap significantly in that myocardial infarct is a major cardiovascular event for which we want to gauge risk. Measuring markers such as CK-MB or troponins allows us to confirm or rule out myocardial infarction. In contrast, risk markers are a tool we can use to assess a person's risk for cardiac morbidity or mortality. When considering markers for myocardial infarct, most laboratorians know that CK-MB and troponin can provide valuable diagnostic and sometimes even prognostic information. But is it time to phase-out CK-MB testing given the performance and demonstrated superiority of troponin testing? In this series we review the use of troponin and CK-MB in contemporary laboratory practice.

This journal also discusses the value and supporting data for genetic assessment of patients at risk for coronary artery disease. Clinical laboratorians are no doubt aware that a genetic component exists when predicting cardiovascular risk. The linkages, specific genes and utility of genetic testing with regard to cardiovascular disease…