非ST段抬高型心肌梗死：在肌钙蛋白时代它是真实存在的吗？（你提供的原文标题似乎有误，推测可能正确标题为“Non-ST-segment elevation myocardial infarction: Is it real in the troponin era?” ，上述译文是按照推测后的标题翻译，若标题无误，请告知我）

Aborted myocardial infarction: is it real in the troponin era?

作者信息

Vasile Vlad C, Babuin Luciano, Ting Henry H, Bell Malcolm R, Orme Nicholas M, Yuan Brandon Y, Perez Jose A Rio, Alegria Jorge R, Bellolio Fernanda, Haro Luis H, Jaffe Allan S

机构信息

Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.

出版信息

Am Heart J. 2009 Apr;157(4):636-41. doi: 10.1016/j.ahj.2008.12.005. Epub 2009 Jan 31.

DOI:10.1016/j.ahj.2008.12.005

PMID:19332189

Abstract

BACKGROUND

Cardiac troponins are the markers of choice for the diagnosis of acute myocardial infarction. The objective of this study was to compare the frequency of "aborted myocardial infarction" (no detectable myocardial injury) determined by measurement of troponin versus that determined by creatine kinase (CK) and creatine kinase-muscle brain (CK-MB) measurement criteria among patients with ST-elevation myocardial infarction (STEMI) who received reperfusion therapy.

METHODS

Since 2004, the Mayo Clinic (Rochester, MN) has had a standard reperfusion protocol for the treatment of patients with STEMI. During the study period, 767 patients presented with new or presumed new ST elevation or left bundle block.

RESULTS

The diagnosis of STEMI was confirmed in 765 (99.7%) patients. Using the 99th percentile cutoff value, troponin T elevations occurred in 765 (100%) of 765 patients when serial samples were available. Creatine kinase-MB levels of twice or more the upper limit of normal occurred in 681 (90.1%) of 749 patients with serial samples for CK-MB, and CK equal or greater than twice the gender-specific upper limits of normal occurred in 521 (78.8%) of 661 patients with serial samples for CK available.

CONCLUSION

The frequency of aborted myocardial infarction is 0% when using troponin at the 99th percentile cutoff as recommended by contemporary guidelines from the European Society of Cardiology (Nice, France) and American College of Cardiology (Washington, DC).

摘要

背景

心肌肌钙蛋白是诊断急性心肌梗死的首选标志物。本研究的目的是比较在接受再灌注治疗的ST段抬高型心肌梗死（STEMI）患者中，通过肌钙蛋白测量确定的“非持续性心肌梗死”（无可检测到的心肌损伤）频率与通过肌酸激酶（CK）和肌酸激酶同工酶（CK-MB）测量标准确定的频率。

方法

自2004年以来，梅奥诊所（明尼苏达州罗切斯特）对STEMI患者有标准的再灌注治疗方案。在研究期间，767例患者出现新的或疑似新的ST段抬高或左束支传导阻滞。

结果

765例（99.7%）患者确诊为STEMI。采用第99百分位数临界值，当有系列样本时，765例患者中有765例（100%）肌钙蛋白T升高。在有CK-MB系列样本的749例患者中，681例（90.1%）的肌酸激酶同工酶水平为正常上限的两倍或更高，在有CK系列样本的661例患者中，521例（78.8%）的CK等于或大于性别特异性正常上限的两倍。