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首页> 外文期刊>Canadian Journal of Emergency Medicine >LO10: Low high-sensitivity troponin concentrations identify low-risk chest pain patients unlikely to benefit from further risk stratification
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LO10: Low high-sensitivity troponin concentrations identify low-risk chest pain patients unlikely to benefit from further risk stratification

机译：LO10：低高敏感性肌钙蛋白浓度鉴定低风险的胸痛患者，不太可能受益于进一步的风险分层

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Introduction: Very low high-sensitivity troponin-T (hs-cTnT) concentrations on presentation can rule out acute myocardial infarction (AMI), but the ability to identify patients at low risk of 30-day major adverse cardiac events (MACE) is less clear. This study examines the sensitivity of low concentrations of hs-cTnT on presentation to rule out 30-day MACE. Methods: This prospective cohort study enrolled emergency department chest pain patients with non-ischemic ECGs who underwent AMI rule-out with an hs-cTnT assay. The primary outcome was 30-day MACE; secondary outcomes were individual MACE components. Because guidelines recommend using a single hs-cTnT strategy only for patients with more than 3-hours since symptom onset, a subgroup analysis was performed for this population. Outcomes were adjudicated based on review of medical records and telephone follow-up. Results: Of 1,167 patients enrolled, 125 (10.7%) experienced 30-day MACE and 97 (8.3%) suffered AMI on the index visit. More than one-third (35.6%) had presenting hs-cTnT concentrations below the limit of detection (5ng/L), which was 94.4% (95%CI 88.8-97.7%) sensitive for 30-day MACE and 99.0% (95%CI 94.5-100%) sensitive for index AMI. Of 292 (25.0%) patients with hs-cTnT?3-hours since symptom onset, low hs-cTnT concentrations on presentation confer a very low risk of 30-day MACE. In the absence of a high risk clinical presentation, further risk stratification is likely to be low yield.
机译：介绍：非常低的高敏感性肌钙蛋白-T（HS-CTNT）呈现出呈递的浓度可以排除急性心肌梗死（AMI），但能够鉴定低风险的患者的30天主要不利心脏事件（MACE）较少清除。本研究探讨了低浓度HS-CTNT对呈现为30天的术士的敏感性。方法：该预期队列研究注册了急诊肿瘤患者，患有非缺血ECG的患者，患有HS-CTNT测定的AMI排除。主要结果是30天的爵士;二次结果是个体术术组件。由于指南建议仅针对症状发作以来超过3小时以上的患者使用单个HS-CTNT策略，对该人群进行亚组分析。根据医疗记录和电话随访审查，裁定结果。结果：1,167名患者入学，125名（10.7％）经验丰富的30天梅斯，97名（8.3％）遭受了IMI的指数访问。超过三分之一（35.6％）呈现出低于检测极限（5ng / l）的HS-CTNT浓度，其为94.4％（95％CI 88.8-97.7％）敏感30天的爵士，99.0％（95 ％CI 94.5-100％）对指数AMI敏感。 292例（25.0％）HS-CTNT患者α-CTNT？由于症状发作以来3小时，呈现的低HS-CTNT浓度赋予30天均匀的风险非常低。在没有高风险临床介绍的情况下，进一步的风险分层可能是低产量。

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