Vasile Vlad C, Jaffe Allan S
Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic College of Medicine, Gonda 5, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Laboratory Medicine and Pathology, Edmonton, AB, T6G 2R3, Canada.
Curr Cardiol Rep. 2017 Aug 24;19(10):92. doi: 10.1007/s11886-017-0904-4.
High-sensitivity cardiac troponin (hscTn) assays are replacing the older-generation assays used to detect myocardial injury because they have improved analytical sensitivity and lead to a more rapid diagnosis of acute myocardial infarction (AMI) and enhanced risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). This review focuses on advantages and difficulties of using hscTn as diagnostic and prognostic tools in acute coronary syndromes (ACS).
The newer assays have a lower specificity for AMI as compared to conventional assays, potentially leading to an increased number of unwarranted hospitalizations and amplified cost unless how to use these assays appropriately is appreciated. Several approaches can increase the specificity of the high sensitivity assays. This review will present the current literature data regarding the use of hscTn assays and will focus on modalities used to increase the specificity, as well as the advantages and pitfalls of using the high sensitivity approach in clinical practice.
高敏心肌肌钙蛋白（hscTn）检测方法正在取代用于检测心肌损伤的旧一代检测方法，因为它们提高了分析灵敏度，能更快速地诊断急性心肌梗死（AMI），并改善非ST段抬高急性冠状动脉综合征（NSTE-ACS）患者的风险分层。本综述重点关注在急性冠状动脉综合征（ACS）中使用hscTn作为诊断和预后工具的优势与困难。
与传统检测方法相比，新型检测方法对AMI的特异性较低，除非正确认识如何恰当使用这些检测方法，否则可能导致不必要住院人数增加和成本上升。有几种方法可以提高高敏检测方法的特异性。本综述将展示有关使用hscTn检测方法的当前文献数据，并重点关注用于提高特异性的方法，以及在临床实践中使用高敏方法的优势和陷阱。
