Department of Clinical Biochemistry, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Emerg Med J. 2013 Jul;30(7):593-4. doi: 10.1136/emermed-2012-201574. Epub 2012 Jul 31.
High-sensitivity troponin assays facilitate the rapid exclusion of acute myocardial infarction (AMI). However, elevated results are also seen in other conditions causing myocardial injury. Serial measurements increase the specificity for AMI, helping to rapidly identify patients for whom revascularisation may be appropriate. In this study, we explore a strategy for rapidly excluding AMI in symptomatic patients using serial high-sensitivity troponin measurements.
(1) all patients presenting more than 3 h after symptom onset with a negative result had a second negative result; (2) AMI was excluded in all patients with two results falling below the lower limit of detection of a standard troponin assay by 8 h post-symptom onset.
高敏肌钙蛋白检测有助于快速排除急性心肌梗死（AMI）。然而，在其他引起心肌损伤的情况下也会出现升高的结果。连续测量可提高 AMI 的特异性，有助于快速确定可能需要血运重建的患者。在这项研究中，我们探讨了一种使用连续高敏肌钙蛋白检测快速排除有症状患者 AMI 的策略。
（1）所有症状发作后 3 小时以上就诊且结果为阴性的患者均获得第二次阴性结果；（2）所有两次结果均低于症状发作后 8 小时标准肌钙蛋白检测下限的患者均排除 AMI。
