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Biomarkers represent a major technological innovation in medicine. This article discusses the definition and uses of biomarkers, particularly their role in diagnosis, risk stratification and management of disease. It reviews the current roles of the seven most commonly used biomarkers in the acute setting (troponin, creatine kinase, myoglobin, brain natriuretic peptide, d-dimer, C-reactive protein, procalcitonin). The article looks briefly at the utility of point-of-care testing, which, despite concerns about accuracy, can help to risk-stratify patients more efficiently at the point of presentation. Biomarkers currently in development for diagnosis and prognostication across a spectrum of disease are surveyed.