National Heart Centre, Singapore, Singapore; Duke-National University of Singapore, Singapore, Singapore; University Medical Centre Groningen, the Netherlands.
Manila Doctors Hospital, Manila, Philippines.
Int J Cardiol. 2019 May 1;282:93-98. doi: 10.1016/j.ijcard.2019.01.107. Epub 2019 Feb 1.
Cardiac troponin is a sensitive and specific biomarker for acute myocardial injury and has been used in the diagnosis of acute coronary syndromes, and has emerged as a tool for identifying high risk individuals for primary preventive therapy. Recent evidence has emerged indicating that high-sensitivity cardiac troponin assays, which allow robust detection of very low troponin concentrations, could detect subclinical injury in asymptomatic patients. On 24 March 2018, a group of cardiologists from the Asia Pacific region convened to review the data and discuss the potential utility of high-sensitivity troponin I (hsTnI) in the risk assessment of cardiovascular disease in the general population. The group recognized the immense burden of cardiovascular disease in the Asia-Pacific region, and the limitations of current risk stratification strategies. Data demonstrates that cardiac biomarkers like hsTnI could improve risk stratification, and thresholds for hsTnI in cardiovascular disease risk classification have been developed in Caucasian populations but not validated in Asian populations. There is an urgent need to improve cardiovascular risk assessment in the Asia Pacific general population, validate the Asian threshold of high risk and prove the utility of targeting these high-risk individuals for primary preventive strategies.
心肌肌钙蛋白是急性心肌损伤的一种敏感和特异的生物标志物，已用于急性冠状动脉综合征的诊断，并已成为识别初级预防治疗高危个体的工具。最近有证据表明，高敏心肌肌钙蛋白检测可灵敏地检测到非常低的肌钙蛋白浓度，可检测无症状患者的亚临床损伤。2018 年 3 月 24 日，来自亚太地区的一组心脏病专家召开会议，审查数据并讨论高敏肌钙蛋白 I（hsTnI）在普通人群心血管疾病风险评估中的潜在应用。专家组认识到亚太地区心血管疾病的巨大负担，以及目前风险分层策略的局限性。数据表明，hsTnI 等心脏生物标志物可改善风险分层，并且已经在白种人群中制定了心血管疾病风险分类的 hsTnI 阈值，但尚未在亚洲人群中验证。迫切需要改善亚太普通人群的心血管风险评估，验证高危人群的亚洲阈值，并证明针对这些高危人群采取初级预防策略的实用性。
