Cardiac
ischemia associated with
acute coronary syndrome and
myocardial infarction is a leading cause of mortality and morbidity in the world. A rapid detection of the ischemic events is critically important for achieving timely diagnosis, treatment and improving the patient's survival and functional recovery. This minireview provides an overview on the current
biomarker research for detection of acute cardiac
ischemia. We primarily focus on
inosine and
hypoxanthine, two by-products of
ATP catabolism. Based on our published findings of elevated plasma concentrations of
inosine/
hypoxanthine in animal laboratory and clinical settings, since 2006 we have originally proposed that these two
purine molecules can be used as rapid and sensitive
biomarkers for acute cardiac
ischemia at its very early onset (within 15 min), hours prior to the release of heart tissue
necrosis biomarkers such as cardiac
troponins. We further developed a chemiluminescence technology, one of the most affordable and sensitive analytical techniques, and we were able to reproducibly quantify and differentiate total
hypoxanthine concentrations in the plasma samples from healthy individuals versus patients suffering from
ischemic heart disease. Additional rigorous clinical studies are needed to validate the plasma
inosine/
hypoxanthine concentrations, in conjunction with other current cardiac
biomarkers, for a better revelation of their diagnostic potentials for early detection of acute cardiac
ischemia.