1型心肌梗塞在患有急性缺血性中风的患者中
Christian H Nolte1,2,3,4, Regina von Rennenberg1,2,5, Simon Litmeier1,2,5
1Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
JAMA neurology
|June 3, 2024
概括
在急性缺血性中风患者中,高灵敏性心脏素 (hs-cTn) 的动态变化并不表明心肌梗塞 (MI). 然而,非常高的hs-cTn水平可能表明1型MI,需要进一步调查.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 生物标志物 生物标志物
背景情况:
- 在急性缺血性中风 (AIS) 患者中,心脏高灵敏度心脏素 (hs-cTn) 的升高是常见的,与不良结果相关.
- 在AIS中hs-cTn升高的诊断和治疗意义仍然不清楚.
研究的目的:
- 在AIS患者中确定暗示心肌梗塞 (MI) 的因素,患者的hs-cTn.
- 测试一个动态hs-cTn变化 (>50%) 表示在AIS中MI的假设.
主要方法:
- 在26个德国地点进行前性观察性研究.
- 包括AIS患者在入院时hs-cTn升高或hs-cTn发生显著变化.
- 标准化的心电图,心声学和冠状动脉血管学用于MI诊断.
主要成果:
- 在247名患者中,51%患有心脏病发作,20%患有1型心脏病发作.
- 动态hs-cTn变化与MI (OR 1.05;95% CI 0.31-3.33) 没有关联.
- 高基线hs-cTn值 (5-10x正常的上限) 独立预测1型MI.
结论:
- 动态hs-cTn变化不能可靠地识别AIS患者的MI.
- 非常高的绝对hs-cTn水平与1型MI有关.
- 需要进一步的研究,以优化冠状动脉血管学选择中风患者.
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