在早期呈现者中,托罗邦尼可以排除心肌梗塞发作
Matthew T H Lowry1, Dimitrios Doudesis1,2, Jasper Boeddinghaus1
1BHF Centre for Cardiovascular Science, University of Edinburgh, Room SU.226, Chancellor's Building, Edinburgh EH16 4SB, UK.
European heart journal
|June 23, 2023
概括
在检测极限以下的一次高灵敏性心脏托罗邦素I测量可以安全地排除早期呈现者的心肌梗塞. 第99个百分点不适合在任何时间点排除心肌梗塞.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 紧急医疗 紧急医疗
背景情况:
- 心肌梗塞的诊断依赖于连续的类素测量.
- 在早期呈现者中单个托罗邦尼测量的实用性仍然不确定.
研究的目的:
- 为了评估单次高灵敏度心脏托罗邦素I测量的诊断性能,在出现可能的心肌梗塞的患者中,在症状出现的几个小时内进行测量.
- 为了评估特定的热素值来排除早期呈现者的心肌梗塞.
主要方法:
- 在怀疑心肌梗塞的患者中,在呈现时评估了单个高灵敏度的心脏托罗邦素I测量.
- 该研究比较了检测极限 (2 ng/L),排除极限 (5 ng/L) 和性别特定的99 个百分点值.
- 外部验证是在一个单独的患者队列上进行的.
主要成果:
- 在3小时内出现的患者中,2 ng/L的门显示出较高的灵敏度 (99.4%) 和负预测值 (99.7%),与5 ng/L相比.
- 对于出现3小时或更晚的患者,对于2 ng/L和5 ng/L值,灵敏度和负预测值是相似的.
- 第99个百分点的值显示,在早期和晚期呈现者中,敏感性较低.
结论:
- 在低于检测极限 (2 ng/L) 的高灵敏度心脏素I单次测量可以在早期呈现者中安全排除心肌梗塞.
- 第99个百分点的值不建议排除心肌梗塞在呈现时,即使在以后的呈现者.
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