原创力文档high-sensitivity versus conventional troponin in the emergency department for the diagnosis of acute myocardial infarction高灵敏度和传统的肌钙蛋白诊断急性心肌梗死的急诊.pdfVIP
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high-sensitivity versus conventional troponin in the emergency department for the diagnosis of acute myocardial infarction高灵敏度和传统的肌钙蛋白诊断急性心肌梗死的急诊
Freund et al. Critical Care 2011, 15:R147
/content/15/3/R147
RESEARCH Open Access
High-sensitivity versus conventional troponin in
the emergency department for the diagnosis of
acute myocardial infarction
1* 2 1 3 3
Yonathan Freund , Camille Chenevier-Gobeaux , Pascale Bonnet , Yann-Erick Claessens , Jean-Christophe Allo ,
Benoit Doumenc4 1 5 1,6 1,6
, François Leumani , Claudine Cosson , Bruno Riou and Patrick Ray
Abstract
Introduction: Recently, newer assays for cardiac troponin (cTn) have been developed which are able to detect
changes in concentration of the biomarker at or below the 99th percentile for a normal population. The objective
of this study was to compare the diagnostic performance of a new high-sensitivity troponin T (HsTnT) assay to that
of conventional cTnI for the diagnosis of acute myocardial infarction (AMI) according to pretest probability (PTP).
Methods: In consecutive patients who presented to our emergency departments with chest pain suggestive of
AMI, levels of HsTnT were measured at presentation, blinded to the emergency physicians, who were asked to
estimate the empirical PTP of AMI. The discharge diagnosis was adjudicated by two independent experts on the
basis of all available data.
Results: A total of 317 patients were included, comprising 149 (47%) who were considered to have low PTP, 109
(34%) who were considered to have moderate PTP and 59 (19%) who were considered to have high PTP. AMI was
confirmed in 45 patients (14%), 22 (9%) of whom were considered to have low to moderate PTP and 23 (39%) of
whom were considered to have h
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