The value of biochemical markers for risk stratification prior to hospital admission in acute chest pain.
The value of biochemical markers for risk stratification prior to hospital admission in acute chest pain.
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DOI：
10.1080/17482940802409662
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Svensson, L
中科院分区：
文献类型：
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作者：
Herlitz, J;Svensson, L
我们描述了使用生化标志物在院前设置方面的诊断准确性检测急性心肌梗死（AMI）和预后与急性胸痛。据报道，灵敏度有限;血液采样发生得很早，通常在生化标志物释放到循环中之前。特异性在某些研究中也是有限的，但这更难以解释。在一项小型试点研究中，新的生化标志物如人心脏脂肪酸结合蛋白（H-FACB）与传统的生化标志物如肌钙蛋白、肌酸激酶（CK-MB）和肌红蛋白相比，在院前环境中显示出更高的诊断准确性。然而，在最近的一项小型研究中，据报告，在入院前进行分析时，肌钙蛋白I的敏感性（当使用心肌损伤的低决策限时）非常高。后一种数据需要在更大的研究中得到证实，并且在任何标记物的分析可以推荐用于疑似AMI的院前设置之前，需要测试反映疾病的各种病理生理学方面的各种生化标记物。
We describe the use of biochemical markers in the pre-hospital setting with regard to diagnostic accuracy for the detection of an acute myocardial infarction (AMI) and for prognosis in connection with acute chest pain. The sensitivity has been reported to be limited; blood sampling occurs very early and often prior to the release of biochemical markers into the circulation. The specificity was in some studies also limited, but this is more difficult to explain. New biochemical markers like human heart fatty acid binding protein (H-FACB) have shown improved diagnostic accuracy, in the pre-hospital setting, in one small pilot study compared with traditional biochemical markers like troponins, creatine kinase (CK-MB) and myoglobin. However, in a recent small study, the sensitivity for troponin I (when a low decision limit for myocardial damage was used), when analysed prior to hospital admission, was reported to be very high. The latter data need to be confirmed in larger studies and various biochemical markers reflecting various pathophysiological aspects of the disease need to be tested before the analysis of any marker can be recommended for use in the pre-hospital setting of a suspected AMI.