García de la Villa B, Díaz-Buschmann I, Alfonso Jurado J, García R, Javier Parra F, Medina J, San Martín M A, de los Reyes M, Hernández-Madrid A, Manuel del Rey J, Manuel Escribano J
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid.
Rev Esp Cardiol. 1998 Feb;51(2):122-8. doi: 10.1016/s0300-8932(98)74721-9.
Cardiac troponin I is a highly sensitive and specific myocardial injury marker. We have analyzed the use of cardiac troponin I values in the diagnosis of coronary artery disease, in previously healthy patients who developed chest pain with inconclusive analytical and ECG diagnostic findings.
PATIENTS, MATERIAL AND METHODS: A one year cross-sectional consecutive study was conducted, in a total of 37 patients with no previously known heart disease who were admitted to the coronary unit for suspected anginal chest pain with normal cardiac enzymes and ECG. Abnormal cardiac troponin I levels at admission were defined as > or = 0.4 ng/ml, and were compared with coronary angiography or exercise test results and related to the duration of pain and the time from the appearance of symptoms to blood extraction.
Thirty-three of the 37 initially included patients were studied. Coronary artery disease was diagnosed in 22, 15 of whom had increased troponin I values, yielding a sensitivity of 68% (48%-84%) and a specificity of 82% (53%-97%). In the subgroup of patients with pain lasting > 30 min, sensitivity reached 85% (59%-97%) and specificity 83% (42%-99%). There were no significant differences between subgroups with different time delays from appearance of symptoms to blood extraction.
Cardiac troponin I is very useful for the studying ischemic chest pain without a definitive diagnostic ECG nor biochemical data, resulting in a high sensitivity and specificity for myocardial ischemic injury detection. Its diagnostic value increases in cases of prolonged pain episodes.
心肌肌钙蛋白I是一种高度敏感且特异的心肌损伤标志物。我们分析了心肌肌钙蛋白I值在诊断冠状动脉疾病中的应用，这些患者既往健康，出现胸痛，但其分析和心电图诊断结果不明确。
患者、材料与方法：进行了一项为期一年的横断面连续研究，共纳入37例既往无心脏病史的患者，这些患者因疑似心绞痛性胸痛入住冠心病监护病房，心肌酶和心电图正常。入院时心肌肌钙蛋白I水平异常定义为≥0.4 ng/ml，并与冠状动脉造影或运动试验结果进行比较，并与疼痛持续时间以及从症状出现到采血的时间相关。
最初纳入的37例患者中有33例接受了研究。22例被诊断为冠状动脉疾病，其中15例肌钙蛋白I值升高，敏感性为68%（48%-84%），特异性为82%（53%-97%）。在疼痛持续时间>30分钟的患者亚组中，敏感性达到85%（59%-97%），特异性为83%（42%-99%）。从症状出现到采血的不同时间延迟亚组之间无显著差异。
心肌肌钙蛋白I对于研究无明确诊断性心电图和生化数据的心源性胸痛非常有用，对心肌缺血性损伤检测具有高敏感性和特异性。在疼痛发作时间延长的情况下，其诊断价值增加。
