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亚太心脏病学会(APSC)专家委员会关于在急诊科使用高敏心肌肌钙蛋白 T 评估疑似急性冠状动脉综合征的共识推荐意见。

The Asia-Pacific Society of Cardiology (APSC) Expert Committee Consensus Recommendations for Assessment of Suspected Acute Coronary Syndrome Using High-Sensitivity Cardiac Troponin T in the Emergency Department.

机构信息

Department of Cardiology, National Heart Centre Singapore.

Department of Cardiology, Sengkang General Hospital.

出版信息

Circ J. 2020 Jan 24;84(2):136-143. doi: 10.1253/circj.CJ-19-0874. Epub 2019 Dec 18.

Abstract

The Asia-Pacific Society of Cardiology (APSC) high-sensitivity troponin T (hs-TnT) consensus recommendations and rapid algorithm were developed to provide guidance for healthcare professionals in the Asia-Pacific region on assessing patients with suspected acute coronary syndrome (ACS) using a hs-TnT assay. Experts from Asia-Pacific convened in 2 meetings to develop evidence-based consensus recommendations and an algorithm for appropriate use of the hs-TnT assay. The Expert Committee defined a cardiac troponin assay as a high-sensitivity assay if the total imprecision is ≤10% at the 99th percentile of the upper reference limit and measurable concentrations below the 99th percentile are attainable with an assay at a concentration value above the assay's limit of detection for at least 50% of healthy individuals. Recommendations for single-measurement rule-out/rule-in cutoff values, as well as for serial measurements, were also developed. The Expert Committee also adopted similar hs-TnT cutoff values for men and women, recommended serial hs-TnT measurements for special populations, and provided guidance on the use of point-of-care troponin T devices in individuals suspected of ACS. These recommendations should be used in conjunction with all available clinical evidence when making the diagnosis of ACS.

摘要

亚太心脏病学会(APSC)高敏肌钙蛋白 T(hs-TnT)共识建议和快速算法旨在为亚太地区的医疗保健专业人员提供指导,使用 hs-TnT 检测评估疑似急性冠状动脉综合征(ACS)患者。来自亚太地区的专家在 2 次会议上共同制定了基于证据的共识建议和 hs-TnT 检测的合理使用算法。专家委员会将心肌钙蛋白检测定义为高敏检测,如果总不精密度在第 99 百分位上限的 99%处≤10%,并且在检测限以上的浓度值处可达到第 99 百分位上限以下的可测量浓度至少 50%的健康个体。还制定了单次测量排除/纳入的临界值值的建议,以及用于连续测量的建议。专家委员会还为男性和女性采用了类似的 hs-TnT 临界值值,建议对特殊人群进行连续 hs-TnT 测量,并就疑似 ACS 个体中使用即时检测肌钙蛋白 T 设备提供指导。在诊断 ACS 时,应结合所有可用的临床证据使用这些建议。

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