Department of General and Interventional Cardiology, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Martinistrasse 52, 20246 Hamburg, Germany.
Nat Rev Cardiol. 2017 Aug;14(8):472-483. doi: 10.1038/nrcardio.2017.48. Epub 2017 Apr 6.
Troponin is a widely used biomarker in patients with cardiac disease. The use of troponin is well established in patients with suspected acute myocardial infarction (AMI), but troponin measurement is also used in other acute and nonacute settings. In patients with suspected AMI, early decision-making is crucial to allow rapid treatment and further diagnostic evaluation. Current guidelines recommend serial measurements of troponin with a cut-off concentration at the 99th percentile to triage patients in the emergency department. Newer, high-sensitivity assays for troponin enable the detection of distinctly lower concentrations. Using these assays and very low cut-off concentrations, several rapid diagnostic strategies have been reported to improve diagnosis in acute cardiac care. Furthermore, noncoronary and nonacute applications of troponin assays - for example as a biomarker in patients with heart failure, pulmonary embolism, or stable coronary artery disease - are on the horizon and might improve individual risk stratification. In this Review, we provide an overview on the development of high-sensitivity assays for troponin, and their application in patients with cardiac disease.
肌钙蛋白是心脏病患者广泛使用的生物标志物。肌钙蛋白的使用在疑似急性心肌梗死（AMI）患者中已经得到很好的证实，但肌钙蛋白测量也用于其他急性和非急性情况下。在疑似 AMI 患者中，早期决策至关重要，以便能够快速治疗和进一步进行诊断评估。目前的指南建议对肌钙蛋白进行连续测量，以第 99 百分位数的截断浓度对急诊科的患者进行分诊。新的高灵敏度肌钙蛋白检测方法能够检测到明显更低的浓度。使用这些检测方法和非常低的截断浓度，已经报道了几种快速诊断策略，以改善急性心脏护理中的诊断。此外，肌钙蛋白检测的非冠状动脉和非急性应用 - 例如在心力衰竭、肺栓塞或稳定型冠状动脉疾病患者中作为生物标志物 - 即将出现，并可能改善个体风险分层。在这篇综述中，我们概述了高灵敏度肌钙蛋白检测方法的发展，以及它们在心脏病患者中的应用。
