血脂谱和肌钙蛋白阳性在预测心脏事件中的意义。

The significance of lipid profile and positive troponin in predicting cardiac event.

作者信息

De Silva L D R, Kumar A, Sathian B

机构信息

Department of Biochemistry, Manipal College of Medical Sciences, Pokhara, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2009 Jul-Sep;7(27):263-7. doi: 10.3126/kumj.v7i3.2735.

DOI:10.3126/kumj.v7i3.2735

PMID:20071874

Abstract

BACKGROUND

Diagnosis of Acute cardiac event in the early stage of its onset is important in the treatment process. The development of highly sensitive and specific immunoassays for myocardial proteins such as cardiac Troponin I (cTnI) had made it possible. However Troponin indicates cardiac events only after its onset or after cardiac tissue necrosis. Traditionally such high risk subjects were identified using lipid profiles. The identification of subjects with high risk of developing cardiac event in the future is more significant as it will provide time to prevent such incidents.

OBJECTIVES

In this study we proposed to study the usefulness of traditional lipid profile levels in screening subjects who had developed chest pain due to cardiac event as indicated by a positive Troponin I test.

MATERIALS AND METHODS

In this retrospective study data of the 259 patients presented to the emergency department with symptoms of cardiac ischemia who underwent both Troponin and lipid profiles tests were compared with the lipid profiles of 105 normal healthy subjects (controls). The Troponin was detected qualitatively when a specimen contains Troponin I (cTnI) above the 99th percentile (TnI >0.5 ng/ml). The Total cholesterol (TC), High density lipoproteins cholesterol (HDL), Very low density lipoproteins (VLDL), and Triacyl glycerol levels (TG) were also analysed and low density lipoprotein level (LDL) was calculated using Friedelwald formula.

RESULTS

Subjects with chest pain and positive Troponin test (with confirmed cardiac event) were found to have significantly elevated levels of TC, TG , LDL and significantly reduced HDL levels when compared to the subjects who had only chest pain (Negative Troponin) and healthy controls.

CONCLUSION

Traditional lipid profile levels still can be used in screening populations to identify the subjects with high risk of developing cardiac event which is identified by highly sensitive and specific positive Troponin test.

摘要

背景

急性心脏事件在发病早期进行诊断对治疗过程至关重要。针对心肌蛋白如心肌肌钙蛋白I（cTnI）的高灵敏度和特异性免疫测定技术的发展使得早期诊断成为可能。然而，肌钙蛋白仅在心脏事件发作后或心肌组织坏死之后才能指示心脏事件。传统上，此类高危人群是通过血脂谱来识别的。识别未来发生心脏事件高风险的人群更为重要，因为这将为预防此类事件提供时间。

目的

在本研究中，我们旨在研究传统血脂谱水平在筛查因心脏事件导致胸痛且肌钙蛋白I检测呈阳性的患者中的作用。

材料与方法

在这项回顾性研究中，将259例因心脏缺血症状就诊于急诊科且同时接受肌钙蛋白和血脂谱检测的患者的数据与105例正常健康受试者（对照组）的血脂谱进行比较。当样本中肌钙蛋白I（cTnI）高于第99百分位数（TnI>0.5 ng/ml）时，对肌钙蛋白进行定性检测。同时分析总胆固醇（TC）、高密度脂蛋白胆固醇（HDL）、极低密度脂蛋白（VLDL）和三酰甘油水平（TG），并使用Friedewald公式计算低密度脂蛋白水平（LDL）。