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[高敏肌钙蛋白I对急诊科晕厥/接近晕厥后心脏病因预测的诊断价值]

[Diagnostic value of high-sensitivity troponin I to predict cardiac causes after syncope/near syncope in emergency department].

作者信息

Hainguerlot S

机构信息

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.

出版信息

Ann Cardiol Angeiol (Paris). 2021 Apr;70(2):86-93. doi: 10.1016/j.ancard.2020.11.005. Epub 2020 Dec 15.

Abstract

AIMS

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.

PROCEDURE

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

过程

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。

结果

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。

结论

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。

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