Background

Myocardial infarction (MI), commonly known as a heart attack, remains one of the leading causes of mortality worldwide. Early diagnosis is critical because timely intervention significantly reduces myocardial damage and improves patient survival. Biomarkers have become indispensable tools in the early detection of MI by providing objective evidence of myocardial injury before clinical manifestations become severe.

Objective

To evaluate the diagnostic performance of commonly used cardiac biomarkers and determine their role in the early detection of myocardial infarction.

Methods

A retrospective observational study was conducted among 1,000 patients presenting with acute chest pain at four tertiary care hospitals between January 2022 and December 2024. Biomarkers including high-sensitivity cardiac troponin I (hs-cTnI), high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase-MB (CK-MB), myoglobin, and B-type natriuretic peptide (BNP) were assessed. Diagnostic accuracy, sensitivity, specificity, and predictive values were analyzed.

Results

Among the 1,000 patients, 432 were diagnosed with acute myocardial infarction. High-sensitivity troponin I demonstrated the highest diagnostic sensitivity (97.2%) and specificity (95.8%). Troponin T showed similar performance with sensitivity of 95.6%. Myoglobin exhibited the earliest elevation but lower specificity. Combined biomarker strategies improved diagnostic accuracy during the first three hours of symptom onset.

Conclusion

Cardiac troponins remain the gold standard biomarkers for early myocardial infarction diagnosis. Integration of multiple biomarkers can improve diagnostic performance, particularly in early presentations. Future biomarker-guided diagnostic protocols may further enhance rapid risk stratification and treatment decisions.