Tota-Maharaj Rajesh, Perera Bhooshan, Murray Jeffrey, Petrini Joann, Keller Andrew M
From the *Department of Medicine, Danbury Hospital, Danbury, CT; †Department of Medicine, St. George's University School of Medicine, St. George, Grenada; ‡Department of Medical Education and Research, Danbury Hospital, Danbury, CT; §Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY; and ¶Department of Medicine, Columbia University, New York, NY.
Crit Pathw Cardiol. 2014 Dec;13(4):147-51. doi: 10.1097/HPC.0000000000000027.
There is little data to support Troponin I (TNI) use in the management of noncardiac patients. We studied the use of TNI in patients on our gastroenterology service, to determine whether there was a change in management as a result of TNI testing.
Patients admitted from September 2011 to June 2012 to our gastroenterology service who had TNI performed were included. Data collected included symptoms, cardiovascular risk factors, medical treatment, and testing.
Sixty-three of 295 patients had a positive TNI. The mean length of stay was significantly longer with a positive troponin (180 vs. 108 hours, P<0.001). Age, hypertension, diabetes, coronary artery disease, and chronic kidney disease were associated with a positive TNI. Cardiac consultation and echocardiography were performed in a higher proportion of TNI positive patients (P<0.0001). There were no statistically significant changes in treatment with clopidogrel, beta-blockers, angiotensin converting enzyme inhibitors, or statins between both groups.
TNI testing in patients admitted to the gastroenterology service was associated with increased length of stay and echocardiography, without any change in management. This study supports adherence to national guidelines for the use of TNI, to reduce TNI testing and length of hospital stay.
几乎没有数据支持肌钙蛋白I（TNI）用于非心脏疾病患者的管理。我们研究了TNI在我院胃肠病科患者中的应用，以确定TNI检测是否会导致管理方式的改变。
纳入2011年9月至2012年6月入住我院胃肠病科且进行了TNI检测的患者。收集的数据包括症状、心血管危险因素、药物治疗和检测情况。
295例患者中有63例TNI呈阳性。肌钙蛋白阳性患者的平均住院时间显著更长（180小时对108小时，P<0.001）。年龄、高血压、糖尿病、冠状动脉疾病和慢性肾病与TNI阳性相关。TNI阳性患者中进行心脏会诊和超声心动图检查的比例更高（P<0.0001）。两组之间在使用氯吡格雷、β受体阻滞剂、血管紧张素转换酶抑制剂或他汀类药物治疗方面没有统计学上的显著变化。
胃肠病科住院患者的TNI检测与住院时间延长和超声心动图检查增加有关，但管理方式没有任何改变。本研究支持遵循国家关于TNI使用的指南，以减少TNI检测和住院时间。
