Should the 1h algorithm for rule in and rule out of acute myocardial infarction be used universally?
Should the 1h algorithm for rule in and rule out of acute myocardial infarction be used universally?
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DOI：
10.1093/eurheartj/ehw282
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发表时间：
2016-11-21
影响因子：
39.3
通讯作者：
Crea, Filippo
中科院分区：
文献类型：
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作者：
Crea, Filippo
最近ESC关于无持续ST段抬高患者急性冠状动脉综合征（NSTE-ACS）管理的指南增加了一种前卫的快速1小时纳入和排除算法，使用高灵敏度心肌肌钙蛋白（hscTn）作为临床选择。1我们认为，指南忽略了定义这些方法的信息中的一些差距，这些方法可能会无意中使患者处于不利地位。其他人报道了在缺血性心肌损伤的“早期呈现者”中使用早期方法进行hscTn测定的不太乐观的结果。[2]下面列出了我们对该指南的关注，以便临床医生能够考虑到这些问题。
The recent ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation (NSTE-ACS) added an avant-garde rapid one hour rule-in and rule-out algorithms using high sensitivity cardiac troponins (hscTn) as a clinical option. 1 In our opinion, the guidelines overlook some gaps in the information that defined these approaches that could inadvertently disadvantage patients. Others report less optimistic results with hscTn assays with early approaches in “early presenters” with ischemia-induced myocardial injury. 2 The following identifies our concerns about that guidelines so that clinicians can take them into account.