Kavsak Peter A, Worster Andrew, Ma Jinhui, Shortt Colleen, Clayton Natasha, Sherbino Jonathan, Hill Stephen A, McQueen Matthew, Mehta Shamir R, Devereaux Philip J
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.
Can J Cardiol. 2017 Jul;33(7):898-903. doi: 10.1016/j.cjca.2017.04.011. Epub 2017 May 3.
The optimal high-sensitivity cardiac troponin (hs-cTn) cutoffs for determining risk in patients who present with acute coronary syndrome symptoms are unknown. In 1137 emergency department patients we calculated adjusted relative risks for a composite outcome (myocardial infarction, unstable angina, heart failure, ventricular arrhythmia, or cardiovascular death) within 7 days for the presentation of hs-cTnT (Roche) and hs-cTnI (Abbott) assay concentrations on the basis of literature cutoffs. Patients with hs-cTn concentrations ≥ 14 ng/L had an adjusted relative risk of 4.9 for the composite outcome, with different hs-cTnT/hs-cTnI concentration ranges yielding higher risks. A common low-risk cutoff of 14 ng/L may be used for hs-cTn with higher cutoffs identifying high-risk patients.
用于确定出现急性冠脉综合征症状患者风险的最佳高敏心肌肌钙蛋白（hs-cTn）临界值尚不清楚。在1137名急诊科患者中，我们根据文献临界值计算了hs-cTnT（罗氏）和hs-cTnI（雅培）检测浓度出现时7天内复合结局（心肌梗死、不稳定型心绞痛、心力衰竭、室性心律失常或心血管死亡）的校正相对风险。hs-cTn浓度≥14 ng/L的患者复合结局校正相对风险为4.9，不同的hs-cTnT/hs-cTnI浓度范围风险更高。hs-cTn可采用14 ng/L这一常见的低风险临界值，更高的临界值用于识别高风险患者。
