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无急性冠状动脉综合征情况下心肌肌钙蛋白对老年患者的影响:一项系统评价。

The impact of cardiac troponin in elderly patients in the absence of acute coronary syndrome: A systematic review.

作者信息

Sedighi Seyed Mahdi, Nguyen Michel, Khalil Abdelouahed, Fülöp Tamas

机构信息

Geriatric Unit, Faculty of Medicine, University of Sherbrooke, Canada.

Cardiology Unit, Faculty of Medicine, University of Sherbrooke, Canada.

出版信息

Int J Cardiol Heart Vasc. 2020 Sep 9;31:100629. doi: 10.1016/j.ijcha.2020.100629. eCollection 2020 Dec.

Abstract

Comorbidities are common risk factors for rising cardiac troponin in non-acute coronary syndromes conditions. Furthermore, the risk for all-cause mortality appears to be correlated to the troponin levels. Consequently, measurement of cardiac troponin in hospital admission may contribute to predict the mortality risk in elderly patients. Among geriatric patients without acute coronary syndrome, with concomitant diseases, the correct interpretation of elevated cardiac troponin, particularly in emergency conditions poses a diagnostic dilemma. Although in several studies it is suggested that at the presence of comorbidity, there is an increase in cardiac troponin values, the elderly patients have not been included conclusively. In order to assess the diagnostic and prognostic role of cardiac troponin elevation in geriatric patients suffering from chronic diseases, a systematic review was performed. The study included the elderly patients free of acute coronary syndrome admitted to the hospital with concomitant disease, with a report of at least one cardiac troponin measurement. We found that elevated cardiac troponin is an independent prognostic factor, predicting all-cause morbidity and mortality burden in geriatric patients without acute coronary syndromes.

摘要

合并症是非急性冠状动脉综合征情况下心肌肌钙蛋白升高的常见危险因素。此外,全因死亡风险似乎与肌钙蛋白水平相关。因此,入院时检测心肌肌钙蛋白可能有助于预测老年患者的死亡风险。在无急性冠状动脉综合征、伴有合并症的老年患者中,对升高的心肌肌钙蛋白进行正确解读,尤其是在紧急情况下,会带来诊断难题。尽管在多项研究中表明,存在合并症时心肌肌钙蛋白值会升高,但老年患者并未被明确纳入。为了评估心肌肌钙蛋白升高在患有慢性疾病的老年患者中的诊断和预后作用,我们进行了一项系统评价。该研究纳入了因合并症入院且无急性冠状动脉综合征的老年患者,这些患者至少有一次心肌肌钙蛋白测量报告。我们发现,心肌肌钙蛋白升高是一个独立的预后因素,可预测无急性冠状动脉综合征的老年患者的全因病 morbidity 和死亡负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75f4/7490820/6978a70d3815/gr1.jpg

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