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【文献翻译】Impact of High-Sensitivity Troponin I Testing with Sex-Spec...

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发表于 2016-6-2 15:02:25 | 显示全部楼层 |阅读模式
Impact of High-Sensitivity Troponin I Testing with Sex-Specific Cutoffs on the Diagnosis of Acute Myocardial Infarction



BACKGROUND: High-sensitivity cardiac troponin I (hs-cTnI) assays show sex-dependent differences in the 99th percentile of healthy populations, with concentrations in women approximately 50% lower. The adoption of sex-specific cutoffs seems appropriate, although it is not yet clear what effect these will have on acute myocardial infarction (AMI) diagnosis and management.

METHODS: We conducted a retrospective pre- and postchangeover analysis of troponin I testing in the 6 months before and after moving from the contemporary Abbott Architect TnI assay (cTnI) to hs-cTnI at 2 tertiary centers in Australia and New Zealand. The cTnI cutoff was 30 ng/L for both sexes, whereas a female-specific cutoff of 16 ng/L was adopted upon changeover to hsTnI.

RESULTS: Changeover from the cTnI assay to the hs-cTnI assay increased the number of female patients with increased troponin I concentrations at both sites (from 29.7% to 34.9% and from 22.4% to 30.8%; P < 0.001). There was no statistically significant change in the number of men with increased concentrations in the same time period (P = 0.09). The increased percentage of women with increased troponin I was not associated with an increase in the number of women with AMI diagnoses at either center. Angiographic data available from 1 center showed no change in the percentage of angiograms performed in women.

CONCLUSIONS: Although increasing the proportion of women with increased troponin I, adopting sex-specific cutoffs with the hs-cTnI assay did not lead to an increase in AMI diagnoses in females, or in the number of women undergoing angiography.

原文链接:http://www.clinchem.org/content/62/6/831.abstract

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发表于 2016-6-3 14:15:07 | 显示全部楼层
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发表于 2016-6-3 15:28:45 | 显示全部楼层
高灵敏度肌钙蛋白I检测性别特定的临界值对诊断急性心肌梗死的影响

       背景:高灵敏度肌钙蛋白I(hs-cTnI)检测方法在99%的健康人群中存在性别差异,女性浓度低约50%。采用性别特异的临界值似乎是可行的,尽管这样的做法对急性心肌梗死(AMI)的诊断和治疗的影响仍是不清楚的。
       方法:我们在澳大利亚和新西兰的2个三级中心进行了一项6个月内肌钙蛋白I分析方法转变前后[即从当代雅培的TnI检测方法(cTnI)转变为hs-cTnI]的回顾性研究。cTnI中,男性和女性的临界值均为30 ng / L;当检测方法转换为hsTnI后,女性特异的临界值采用16 ng/L。
       结果:cTnI检测转换到hs-cTnI检测使两边肌钙蛋白I浓度增加的女性患者数量增加(从29.7%到34.9%和从22.4%到30.8%;P<0.001)。同一时间内,肌钙蛋白I浓度增加的男性患者的变化没有统计学上的显着差异(= 0.09)。肌钙蛋白Ⅰ增加的妇女比例的增加与2个中心急性心肌梗死患者的数量增加不相关。来自其中一个中心的血管造影数据显示,女性血管造影的比例没有变化。
       结论:虽然在女性中肌钙蛋白I增加的比例越来越多,hs-cTnI测定方法采用性别特异的临界值,它并不会导致女性AMI诊断的增加,或女性接受血管造影的数量的增加。
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