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JACC:评估后排除的胸痛患者高灵敏度肌钙蛋白T测定结果

2017-05-29 xiangting MedSci原创

当用hsTnT评估时,以不明原因胸痛被急诊直接排除的患者MACEs更少,风险状况更好。

大部分的胸痛患者在急诊被诊断为"不明原因的胸痛"后离开医院。而对这一群体测定高灵敏度肌钙蛋白T(hsTnT)是否会影响预后尚不清楚。

这项研究旨在调查对于被急诊排除的胸痛患者,引入hsTnT试验是否与降低心脏不良事件(MACEs)和心血管(CV)风险的发生相关。

研究共纳入了65,696例2006年至2013年间瑞典16家医院急诊排除的"不明原因胸痛"患者,引入hsTnT检测作为临床常规。根据国家注册管理机构的信息,比较常规和hsTnT检测,评估患者30天MACE和CV风险的发生。患者直接被排除和入院后再出院者分别进行分析。

与常规检测相比,用hsTnT进行评估时直接排除患者出现MACE比率更少(0.6%vs. 0.9%;优势比[OR]:0.7; 95%置信区间[CI]:0.57至0.83)。相比之下,在用hsTnT评估(7.2%vs. 3.4%; OR:2.18; 95%CI:1.76-2.72)时,入院后出院发生MACE的患者更多。入院患者在用hsTnT评估时具有更高的CV风险,而直接排除的患者具有较低的CV风险。

由此可见,当用hsTnT评估时,以不明原因胸痛被急诊直接排除的患者MACEs更少,风险状况更好。研究结果表明,更多的有真正风险患者的被识别确定和收住院。实施hsTnT测定已经改善了急诊的评估。

原始出处:

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    2017-06-28 hbwxf
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    2017-08-29 respect
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