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background

High-sensitivity data on troponin concentrations in emergency department patients high sensitive troponin i with symptoms of myocardial infarction may help determine the likelihood of myocardial infarction and the subsequent 30-day outcome.

method

In an international cohort of 15 emergency department patients with myocardial infarction-related symptoms, we can determine the concentration of high-sensitivity troponin I or high-sensitivity troponin T during continuous sampling in the early or late stages. The design of a financial derivatives verification system is used to analyze and evaluate the diagnostic and prognostic performance of a variety of high-sensitivity troponin transection combinations. Based on the above information and data, an enterprise risk management assessment research tool was developed to evaluate the risk of myocardial infarction and the subsequent 30 days of myocardial infarction or death through the price index.

result

Among 22,651 patients, the incidence of myocardial infarction was 15.3% (9604 derived data sets and 13,047 valid data sets). The high-sensitivity troponin concentration is low when presented, the absolute change during continuous sampling is small, and it is associated with a low probability of myocardial infarction and a low short-term risk of cardiovascular events. For example, high-sensitivity troponin concentrations below 6 ng/l and absolute changes below 4 ng/l after 45-120 minutes (early sequence sampling) are associated with a negative predictive value of 99.5% for myocardial infarction and are associated with the following 30 days The risk of myocardial infarction or death is related, with a total risk of 0.2%. 56.5% of patients are classified as low-risk groups. These findings are confirmed in an externally verified data set.

in conclusion

We have developed a risk assessment tool that combines the high sensitivity of troponin or troponin t during emergency visits, the dynamic changes during continuous sampling, and the sampling interval to assess the risk of myocardial infarction during emergency visits and 30 The result of days later.

Interpretation: In the international development cohort of 15 emergency department nursing patients with main symptoms of myocardial tissue infarction, the author measured the high-sensitive troponin and the concentration during continuous work sampling in the early or late stage. A total of 10347 patients were verified, and the results were analyzed. It shows that the high-sensitivity troponin concentration is significantly lower than 6 ng/L, and there is absolutely no change after 45-120 minutes. The situation is lower than 4 ng/L (early time series data sampling), resulting in a negative study predictive value of 99.5 for myocardial infarction %, which is related to the subsequent 30-day risk management of myocardial infarction or death, with a total risk of 0.2%.

High-sensitivity troponin can be a good assessment of index myocardial infarction and the risk of myocardial infarction or death in the subsequent 30 days.

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