应激试验阴性人群中高敏肌钙蛋白 T 升高。

Elevated high-sensitive troponin T in negative stress test individuals.

机构信息

Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Department of Statistics, School of Mathematical Science, Tel Aviv University, Tel Aviv, Israel.

出版信息

Eur J Clin Invest. 2018 Jun;48(6):e12930. doi: 10.1111/eci.12930. Epub 2018 Apr 16.

DOI:10.1111/eci.12930

PMID:29577259

Abstract

BACKGROUND

The exercise ECG stress test (EST) is still the first step of work-up in intermediate risk patients in many clinical scenarios. High-sensitive cardiac troponin T (hs-cTnT) elevation is related to future cardiovascular events in the general population and in patients with ischaemic heart disease. The relation between these 2 tests is not well described.

MATERIALS AND METHODS

A total of 2780 participants from the Tel-Aviv Medical Center Inflammation Survey cohort (mean age 49 years, 79% men) were analysed. Multiple physiologic and metabolic parameters including hs-cTnT were collected. All participants completed an EST manually reviewed by a cardiologist.

RESULTS

A positive EST was documented in 224 subjects (8%). The majority (91%) of participants with hs-cTnT levels of 5-14 ng/L had a negative EST as well as 89.3% of subjects with levels >14 ng/L. The proportion of subjects with a positive EST and detectable hs-cTnT levels (>5 ng/L) was not significantly greater compared to those with a negative EST (53.1% vs 46.2%, respectively, P = .09).

CONCLUSION

Among subjects referred for EST as part of an annual health survey, we found no significant association between EST results to hs-cTnT detection.

摘要

背景

在许多临床情况下，运动心电图应激试验（EST）仍然是中危患者的初步检查手段。高敏心肌肌钙蛋白 T（hs-cTnT）升高与普通人群和缺血性心脏病患者的未来心血管事件有关。这两种检测之间的关系尚未得到很好的描述。

材料和方法

对来自特拉维夫医疗中心炎症调查队列的 2780 名参与者（平均年龄 49 岁，79%为男性）进行了分析。收集了包括 hs-cTnT 在内的多种生理和代谢参数。所有参与者均完成了由心脏病专家手动审查的 EST。

结果

224 名（8%）患者的 EST 结果为阳性。大多数（91%）hs-cTnT 水平为 5-14ng/L 的患者的 EST 为阴性，hs-cTnT 水平>14ng/L 的患者中也有 89.3%的 EST 为阴性。与 EST 阴性者相比，EST 阳性且 hs-cTnT 水平可检测（>5ng/L）的患者比例没有显著差异（分别为 53.1%和 46.2%，P=.09）。