Novelties in biomarkers for the management of circulatory failure

PURPOSE OF REVIEW: The purpose of the present work was to review the literature on the role of biomarkers for the diagnosis, the risk stratification, and the management of circulatory failure. RECENT FINDINGS: Recent research has highlighted how biomarkers could guide physicians in making proper diagnosis of the cause of the circulatory failure, assessing the consequence in terms of organ injury and function, refining prognosis prediction and stratification of patients, and guiding treatments, in patients with cardiovascular failure. SUMMARY: Because of the tight association between circulatory and renal failure, we put a special emphasis on cardiovascular [B-type natriuretic peptide (BNP), Nt-proBNP, troponin, QSOX-1, sST-2, mid-regional pro-atrial natriuretic peptide] and renal biomarkers (neutrophil gelatinase-associated lipocalin, cystatin C, liver-type fatty acid-binding protein, kidney injury molecule-1, insulin-like growth factor-binding protein-7, tissue inhibitor of metalloproteinase-2). We also discuss nonspecific biomarkers (pro-ADM, glycemia, MicroRNA, chromogramin A) in this setting. We discuss the potential interest and limits, from diagnosis to prognosis reclassification, of cutting-edge new biomarkers, but also widely available and inexpensive biomarkers, in the particular setting of circulatory failure.