Hainguerlot S
Service d'accueil des urgences, GHT Nord-Ardennes, centre hospitalier de Charleville-Mézières, 45, avenue de Manchester, 08000 Charleville-Mézières Ardennes, France; UFR de médecine de Reims, université de Reims Champagne-Ardenne, 51, rue Cognacq-Jay, CS30018, 51095 Reims cedex, France.
Ann Cardiol Angeiol (Paris). 2021 Apr;70(2):86-93. doi: 10.1016/j.ancard.2020.11.005. Epub 2020 Dec 15.
The objective of this study is to evaluate the diagnostic accuracy of high-sensitivity (hs) troponin I to predict cardiac origin after syncope. The secondary objective is to determine the causes of elevated troponin.
Were included hospitalized patients with syncope/near syncope diagnosed in ED. The diagnostic accuracy to predict cardiac origin was evaluated and compared to the "high risk" group, defined by the 2018 European Society of Cardiology guidelines.
A total of 163 patients were enrolled, 26% had a cardiac origin. Positive troponin I hs predict a cardiac origin with a sensitivity of 31%, a specificity of 80%, positive predictive value of 35% and negative value of 77%. These diagnostic performances are not discriminating and lower than the ESC classification. A positive troponine I hs level is associated with 5 times more cardiac failure during the hospitalization.
A positive troponin I hs level after syncope/near syncope is not predictive of cardiac origin. It appears to be an early marker of ventricular remodeling in heart failure.
本研究的目的是评估高敏肌钙蛋白I预测晕厥后心脏源性病因的诊断准确性。次要目的是确定肌钙蛋白升高的原因。
纳入在急诊科诊断为晕厥/接近晕厥的住院患者。评估预测心脏源性病因的诊断准确性,并与2018年欧洲心脏病学会指南定义的“高风险”组进行比较。
共纳入163例患者,26%有心脏源性病因。高敏肌钙蛋白I阳性预测心脏源性病因的灵敏度为31%,特异度为80%,阳性预测值为35%,阴性预测值为77%。这些诊断性能不具有区分性且低于欧洲心脏病学会的分类。高敏肌钙蛋白I水平阳性与住院期间心力衰竭发生率高5倍相关。
晕厥/接近晕厥后高敏肌钙蛋白I水平阳性不能预测心脏源性病因。它似乎是心力衰竭心室重构的早期标志物。