High-Sensitivity Cardiac Troponin Risk Cutoffs for Acute Cardiac Outcomes at Emergency Department Presentation

被引：22
作者：
Kavsak, Peter A. [1 ]
Worster, Andrew [2 ]
Ma, Jinhui [3 ,4 ]
Shortt, Colleen [1 ]
Clayton, Natasha [5 ]
Sherbino, Jonathan [2 ]
Hill, Stephen A. [1 ]
McQueen, Matthew [1 ]
Mehta, Shamir R. [6 ,7 ]
Devereaux, Philip J. [6 ,7 ]
机构：
[1] McMaster Univ, Dept Pathol & Mol Med, Hamilton, ON, Canada
[2] McMaster Univ, Div Emergency Med, Hamilton, ON, Canada
[3] Univ Ottawa, Sch Epidemiol Publ Hlth & Prevent Med, Ottawa, ON, Canada
[4] Eastern Ontario Res Inst, Childrens Hosp, Ottawa, ON, Canada
[5] McMaster Univ, Dept Med, Hamilton, ON, Canada
[6] McMaster Univ, Div Cardiol, Hamilton, ON, Canada
[7] McMaster Univ, Populat Hlth Res Inst, Hamilton, ON, Canada
来源：
CANADIAN JOURNAL OF CARDIOLOGY | 2017年 / 33卷 / 07期
基金：
加拿大健康研究院;
关键词：
ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROME; RULE-OUT; 99TH PERCENTILE; POPULATION; COHORT; ASSAY; DIAGNOSIS; LIMITS;
D O I：
10.1016/j.cjca.2017.04.011
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
The optimal high-sensitivity cardiac troponin (hs-cTn) cutoffs for determining risk in patients who present with acute coronary syndrome symptoms are unknown. In 1137 emergency department patients we calculated adjusted relative risks for a composite outcome (myocardial infarction, unstable angina, heart failure, ventricular arrhythmia, or cardiovascular death) within 7 days for the presentation of hs-cTnT (Roche) and hs-cTnI (Abbott) assay concentrations on the basis of literature cutoffs. Patients with hs-cTn concentrations >= 14 ng/L had an adjusted relative risk of 4.9 for the composite outcome, with different hs-cTnT/hs-cTnI concentration ranges yielding higher risks. A common low-risk cutoff of 14 ng/L may be used for hs-cTn with higher cutoffs identifying high-risk patients.
引用
收藏
页码：898 / 903
页数：6
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