NEJM:高敏感性肌钙蛋白在疑似心肌梗死患者诊断中的应用

2019-06-27 MedSci MedSci原创

研究认为,综合高敏感性肌钙蛋白I或肌钙蛋白T浓度、连续抽样期间的动态变化可用于心肌梗死的诊断和30天结果预测

理论而言,对急诊疑似心肌梗死患者进行高敏感性肌钙蛋白浓度测定可有助于确诊心肌梗死并预测30天结果。近日研究人员开展大规模临床研究,对上述假设进行验证。

在15个具有心肌梗死症状的急诊队列中,研究人员测定了早期或晚期连续抽样时高敏感肌钙蛋白I或高敏感肌钙蛋白T的浓度,对多种高灵敏度肌钙蛋白组合的诊断和预后性能进行评估。

在22651例患者中,心肌梗死患病率为15.3%,其中模型开发组9604例,验证组13047例。较低的高敏感性肌钙蛋白浓度和较小的连续抽样绝对变化,与心肌梗死的可能性较低以及心血管事件短期风险较低相关。例如,高度敏感的肌钙蛋白I浓度低于6 ng/L,在45至120分钟后绝对变化小于4 ng/L (早期连续抽样),对心肌梗死的阴性预测值为99.5%,随后30天心肌梗死或死亡的相关的风险为0.2%。56.5%的患者将被归类为低风险。这些发现在外部验证数据集中得到了证实。

研究认为,综合高敏感性肌钙蛋白I或肌钙蛋白T浓度、连续抽样期间的动态变化可用于心肌梗死的诊断和30天结果预测。

原始出处:

Johannes T. Neumann et al. Application of High-Sensitivity Troponin in Suspected Myocardial Infarction. N Engl J Med, June 27, 2019.

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    2019-10-12 12052c89m64(暂无昵称)

    厉害

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=373817, encodeId=d8193e3817c0, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/09/07/ebbe509bb8fec1518a4e59f43a41f4db.jpg, createdBy=ed352171566, createdName=12052c89m64(暂无昵称), createdTime=Sat Oct 12 19:01:01 CST 2019, time=2019-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388453, encodeId=97d9138845366, content=<a href='/topic/show?id=7ef25e5346b' target=_blank style='color:#2F92EE;'>#敏感性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57534, encryptionId=7ef25e5346b, topicName=敏感性)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJnkE6UvGFfMS41qV0RicWvVTTeLMicqibeZH5GqO4YhNicyl1Y9jFhylIUBn9ntPYy9jhk5hrfic5cRYw/132, createdBy=5f822500020, createdName=ms5236388012055669, createdTime=Sat Jun 29 10:00:00 CST 2019, time=2019-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=368542, encodeId=b99836854268, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Jun 28 17:22:29 CST 2019, time=2019-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034872, encodeId=3ec410348e27f, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 27 22:00:00 CST 2019, time=2019-06-27, status=1, ipAttribution=)]
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    2019-06-28 1ddf0692m34(暂无匿称)

    学习了,谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=373817, encodeId=d8193e3817c0, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/09/07/ebbe509bb8fec1518a4e59f43a41f4db.jpg, createdBy=ed352171566, createdName=12052c89m64(暂无昵称), createdTime=Sat Oct 12 19:01:01 CST 2019, time=2019-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1388453, encodeId=97d9138845366, content=<a href='/topic/show?id=7ef25e5346b' target=_blank style='color:#2F92EE;'>#敏感性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57534, encryptionId=7ef25e5346b, topicName=敏感性)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJnkE6UvGFfMS41qV0RicWvVTTeLMicqibeZH5GqO4YhNicyl1Y9jFhylIUBn9ntPYy9jhk5hrfic5cRYw/132, createdBy=5f822500020, createdName=ms5236388012055669, createdTime=Sat Jun 29 10:00:00 CST 2019, time=2019-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=368542, encodeId=b99836854268, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Jun 28 17:22:29 CST 2019, time=2019-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034872, encodeId=3ec410348e27f, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 27 22:00:00 CST 2019, time=2019-06-27, status=1, ipAttribution=)]
    2019-06-27 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0