Toward Precision in Myocardial Injury Management: A Critical Synthesis and the C.A.L.I.B.R.A.T.E. Framework for Biomarker Integration.
Cardiovascular diseases remain the leading cause of global mortality, necessitating precise strategies for diagnosing and managing myocardial injury. This review critically synthesizes the current biomarker landscape and proposes an integrative framework to address the significant translational gaps...
| Publicado en: | Clinical Medicine Insights: Cardiology Vol. 20; pp. 1 - 29 |
|---|---|
| Autores principales: | , , , , , , , , |
| Formato: | pictorial review tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
6/11/2026
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194543526&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194543526 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795468 B3KL jtl: Clinical Medicine Insights: Cardiology issn: 11795468 maglogo: Y pubinfo: dt: 6/11/2026 vid: 20 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 194543526 194543526 194543526 10.1177/11795468261454738 194543526 ppf: 1 ppct: 28 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Toward Precision in Myocardial Injury Management: A Critical Synthesis and the C.A.L.I.B.R.A.T.E. Framework for Biomarker Integration. aug: au: Nwokocha, Chukwuemeka Palacios, Javier Kolawole, Tolunigba Nwokocha, Magdalene Anyaorah, Chinelo Chiroma, Joel H. McGrowder, Donovan Orie, Nelson Husaini, Danladi C. affil: Basic Medical Sciences, Faculty of Medical Sciences, University of the West Indies Mona, Jamaica sug: subj: Myocardial Injury Diagnosis Myocardial Injury Therapy Biological Markers Blood Individualized Medicine Diagnosis, Cardiovascular Sensitivity and Specificity Troponin Blood Natriuretic Peptide, Brain Blood C-Reactive Protein Blood Diagnostic Errors Prevention and Control Echocardiography Magnetic Resonance Imaging Kidney Failure, Chronic Complications Heart Failure Diagnosis Heart Failure Therapy ab: Cardiovascular diseases remain the leading cause of global mortality, necessitating precise strategies for diagnosing and managing myocardial injury. This review critically synthesizes the current biomarker landscape and proposes an integrative framework to address the significant translational gaps between biomarker science and clinical practice. We conducted a comprehensive critical review, analyzing established and emerging biomarkers, including cardiac troponins, natriuretic peptides, and inflammatory and fibrotic markers, within the context of biological confounders, etiology-specific challenges, and clinical implementation barriers. Through thematic synthesis, we developed the novel C.A.L.I.B.R.A.T.E. framework to structure biomarker integration. While high-sensitivity assays have improved detection, they reveal chronic elevations in conditions like renal dysfunction, aging, and heart failure, reducing specificity and complicating acute diagnosis. Emerging biomarkers (eg, sST2, galectin-3) offer prognostic insight but lack therapeutic guidance and specificity. Etiology-specific puzzles (eg, myocarditis, COVID-19, MINOCA) highlight the limitations of isolated biomarker interpretation. The C.A.L.I.B.R.A.T.E. framework addresses these gaps by integrating Clinical context, Assay characteristics, Likelihood, Injury mechanism, Biomarker profiles, Rule-out/in thresholds, Adjunctive tests, Time kinetics, and Etiologies & comorbidities. The future of myocardial injury management depends on shifting from isolated biomarker measurement to integrated, algorithm-driven interpretation. The C.A.L.I.B.R.A.T.E. framework provides a structured pathway for personalized diagnostic reasoning, bridging the translational chasm and advancing precision cardiology through context-dependent, multi-modal data synthesis. Plain Language Summary: Diagnosing heart injury using blood tests is complex because factors like age, kidney disease, and other illnesses can skew the results. This review shows that using single tests is often misleading. Instead, doctors should combine multiple test results, imaging scans, and the patient's full medical story to make an accurate diagnosis. We introduce a new practical guide—the C.A.L.I.B.R.A.T.E. approach—to help clinicians integrate all this information, leading to more precise, personalized, and effective care for patients with heart injury. pubtype: Academic Journal doctype: pictorial review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|