Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
J Am Coll Cardiol. 2017 Aug 22;70(8):996-1012. doi: 10.1016/j.jacc.2017.07.718.
High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn-based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI.
高敏心肌肌钙蛋白（hs-cTn）检测自 7 年前问世以来，全球数千名医生已在临床中使用。在急性心肌梗死（MI）的早期诊断中，hs-cTn 检测无疑是最重要的适应证，这些简单、经济、重复性高的检测工具，可补充详细的临床评估，包括胸痛特征和心电图。hs-cTn 检测首次可精准定量检测 99 百分位附近的心肌细胞损伤，从而大大提高了急诊科（ED）就诊时血液样本检测 MI 的准确性。ED 就诊时更高的准确性，推动了基于早期 hs-cTn 的诊断算法的开发和广泛验证，这大大减少了 MI 安全排除或确诊所需的时间。本综述总结了在疑似 MI 患者的 ED 中安全有效使用 hs-cTn 的关键原则。
