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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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热素T和I的升高与异常的组织水平输液有关:TACTICS-TIMI 18子研究. 用阿格拉斯塔特治疗心痛,并确定使用侵入性或保守策略治疗的成本 - - 心肌梗塞中血栓溶解.

Graham C Wong1, David A Morrow, Sabina Murphy

  • 1Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA.

Circulation
|July 10, 2002
PubMed
概括

在非ST升高的急性冠状动脉综合征 (NSTE-ACS) 中心肌托波宁T (cTnT) 的升高与组织输液不良有关. 微血管功能受损独立地预测了较高的cTnT水平和不良结果.

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科学领域:

  • 心脏病学 心脏病学
  • 生物化学 生物化学

背景情况:

  • 在非ST升高急性冠状动脉综合征 (NSTE-ACS) 中心脏中高水平的T (cTnT) 和I水平与不良事件,多血管疾病,复杂病变和血栓相关.
  • 需要进一步阐明NSTE-ACS中热素升高的病理生理机制.

研究的目的:

  • 在NSTE-ACS患者中使用TIMI心肌输液等级 (TMPG) 调查热素升高和心肌组织输液之间的关系.
  • 确定受损组织输液是否是NSTE-ACS中热激素升高和不良结果的独立预测因子.

主要方法:

  • 对来自TACTICS-TIMI 18试验的310名NSTE-ACS患者的分析.
  • 评估TIMI心肌输液等级 (TMPG 0/1 vs. 2/3) 和其与心脏托素T (cTnT) 水平的相关性.
  • 多变量分析以评估TMPG与cTnT升高的独立关联,并根据临床和血管学因素进行调整.

主要成果:

  • 与cTnT阴性患者相比,在皮肤冠状动脉干预前 (58.1%) 和皮肤冠状动脉干预后 (55.4%) 的患者中,cTnT升高的患者显示出显著更多的"封闭"微血管 (TMPG 0/1).
  • 在TMPG 0/1 (0.50 ng/mL) 与TMPG 2/3 (0.31 ng/mL) 的患者中观察到较高的cTnT水平.
  • 损伤组织输液 (TMPG 0/1) 与cTnT升高 (OR,1.81;P=0.02) 独立相关,并与6个月死亡或心肌梗塞风险增加有关.

结论:

  • 异常的组织水平输液,类似于ST升高心肌梗塞,与NSTE-ACS中的不良结果有关.
  • 微血管功能受损独立预测在NSTE-ACS中cTnT升高的风险增加了1.8倍,无论心上动脉流动或血栓存在.