de Lemos James A, deFilippi Christopher R
aDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas bDivision of Cardiology, University of Maryland Medical Center, Baltimore, Maryland, USA.
Coron Artery Dis. 2013 Dec;24(8):705-9. doi: 10.1097/MCA.0000000000000048.
Cardiac troponins, when measured using highly sensitive assays, appear to be among the most powerful prognostic biomarkers yet identified for risk assessment in the general population. Very low troponin levels detectable with these highly sensitive assays are correlated with multiple clinical determinants of future heart failure risk and cardiovascular death. Corresponding imaging evidence of subclinical heart disease includes strong associations between cardiac troponins, left ventricular hypertrophy, and reduced left ventricular ejection fraction. This is in contrast to the poor correlation with coronary disease. Cardiac troponins provide complementary information to natriuretic peptides, as well as measures of renal function, and appear to outperform high-sensitivity C-reactive protein in predicting risk for a variety of cardiovascular disease endpoints. Additional research is now needed to define the role of highly sensitive troponin assays in screening of the general population and risk assessment.
使用高灵敏度检测方法测定时，心肌肌钙蛋白似乎是目前已确定的用于普通人群风险评估的最强大的预后生物标志物之一。通过这些高灵敏度检测方法可检测到的极低肌钙蛋白水平与未来心力衰竭风险和心血管死亡的多种临床决定因素相关。亚临床心脏病的相应影像学证据包括心肌肌钙蛋白、左心室肥厚和左心室射血分数降低之间的密切关联。这与与冠心病的弱相关性形成对比。心肌肌钙蛋白为利钠肽以及肾功能指标提供补充信息，并且在预测各种心血管疾病终点风险方面似乎优于高灵敏度C反应蛋白。现在需要进一步研究来确定高灵敏度肌钙蛋白检测在普通人群筛查和风险评估中的作用。
