Clinical Characteristics and Outcomes of Patients with Myocardial Infarction, Myocardial Injury, and Nonelevated Troponins
Clinical Characteristics and Outcomes of Patients with Myocardial Infarction, Myocardial Injury, and Nonelevated Troponins
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DOI：
10.1016/j.amjmed.2015.11.006
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发表时间：
2016-04-01
影响因子：
5.9
通讯作者：
Mickley, Hans
中科院分区：
文献类型：
--
作者：
Sarkisian, Laura;Saaby, Lotte;Mickley, Hans
背景：心肌肌钙蛋白已成为检测心肌坏死和诊断心肌梗死的首选生物标志物。然而，目前的心肌肌钙蛋白检测不能区分心肌细胞死亡的缺血性和非缺血性原因。因此，当遇到肌钙蛋白值增加，在没有明显的心肌缺血，仔细寻找其他临床条件是至关重要的。方法：在2010年至2011年，我们前瞻性研究了住院患者的心肌肌钙蛋白I测量的临床适应症。在心肌肌钙蛋白I升高或降低模式中至少有1个值> 30 ng/L（第99百分位数）伴心肌缺血的病例中诊断为急性心肌梗死。心肌损伤定义为心肌肌钙蛋白I值> 30 ng/L，但无明显心肌缺血的体征或症状。峰值患者
BACKGROUND: Cardiac troponins have emerged as the preferred biomarkers for detecting myocardial necrosis and diagnosing myocardial infarction. However, current cardiac troponin assays do not discriminate between ischemic and nonischemic causes of myocardial cell death. Thus, when an increased troponin value is encountered in the absence of obvious myocardial ischemia, a careful search for other clinical conditions is crucial.METHODS: In 2010 to 2011, we prospectively studied hospitalized patients who had cardiac troponin I measured on clinical indication. An acute myocardial infarction was diagnosed in cases of a cardiac troponin I increase or decrease pattern with at least 1 value > 30 ng/L (99th percentile) together with myocardial ischemia. Myocardial injury was defined as cardiac troponin I values > 30 ng/L, but without signs or symptoms indicating overt cardiac ischemia. Patients with peak values