在急性胸痛患者中,高灵敏度的托罗宁T度通过心脏计算机断层扫描评估
James L Januzzi1, Fabian Bamberg, Hang Lee
1Massachusetts General Hospital, Boston, MA 02114, USA.
Circulation
|March 3, 2010
概括
高灵敏度的热素T (hsTnT) 试验可以在胸痛患者中更好地检测急性冠状动脉综合征 (ACS). 升高的hsTnT水平表明心肌损伤和严重的心脏病,即使没有正式的ACS诊断.
科学领域:
- 心脏病学 心脏病学
- 生物标志物发现发现
- 紧急医疗 紧急医疗
背景情况:
- 目前的指导方针建议在急性冠状动脉综合征 (ACS) 评估的99百分位点进行心脏托罗宁检测.
- 常规的素测定通常在这些低诊断水平上缺乏必要的精度.
研究的目的:
- 为了评估高灵敏度托罗邦素T (hsTnT) 试验在患有胸痛的患者中的性能.
- 将hsTnT与用于ACS检测的常规素T方法进行比较.
- 探索hsTnT水平与心脏结构/功能之间的关系.
主要方法:
- 一项横截面研究招募了377名患有胸痛和低至中等ACS概率的患者.
- 血液样本使用商业化前的hsTnT测定方法和传统的托罗邦素T方法进行分析.
- 患者还接受了冠状动脉计算机断层扫描血管造影 (CCTA) 进行心脏评估.
主要成果:
- 在99百分点切点 (13 pg/mL) 上,hsTnT测定显示了ACS的62%灵敏度和89%特异性.
- 与传统方法相比,hsTnT检测到的ACS病例比传统方法多了27% (P=.001).
- 升高的hsTnT强烈预测了ACS (OR 9.0) 并与冠状动脉疾病严重程度和左心室异常相关.
结论:
- hsTnT测定为诊断胸痛患者的ACS提供了良好的灵敏度和特异性.
- 升高的hsTnT水平表明心肌损伤和显著的结构性心脏病,无论ACS诊断如何.
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