现场快速检测高敏肌钙蛋白在老年急性心肌梗死早期的临床诊断价值

目的:观察现场快速检测高敏肌钙蛋白I(hs-cTnI)在急诊老年胸痛患者人群中的表达情况,并评价其对急性心肌梗死(AMI)的诊断效能.方法:选择2018年6月-2021年5月期间我院急诊科收治的胸痛疑似急性冠脉综合征(ACS)而行现场快速检测hs-cTnI的315例老年患者作为研究对象,观察hs-cTnI在老年急性胸痛...

Diagnostic efficacy of rapid detection of high-sensitivity troponin in the early stages of acute myocardial infarction in the elderly patients

Objective: To observe the expression of high-sensitivity troponin I(hs-cTnI) by point-of-care testing(POCT) in the elderly patients with chest pain, and evaluate its diagnostic efficacy for acute myocardial infarction(AMI). Methods: A total of 315 elderly patients with acute chest pain who were suspected of acute coronary syndrome(ACS) in the emergency department of our hospital from June 2018 to May 2021 were selected as the research objects to observe the expression of hs-cTnI. The sensitivity and specificity of primary hs-cTnI in elderly patients with AMI were calculated on the basis of the final judgment made by cardiologic experts according to the clinical data of patients and the results of related examinations. The receiver operating characteristic(ROC) curve was drawn to determine the diagnostic value of hs-cTnI in elderly patients with AMI, and the best diagnostic value was calculated. Results: Among the 315 elderly patients with acute chest pain, 93 patients(29.5%) were finally clinically determined to be AMI patients, and 222 patients(70.5%) were non-AMI patients. The overall expression level of hs-cTnI in AMI patients was significantly higher than that in non-AMI patients[(1.150±0.710) ng/mL vs.(0.045±0.014) ng/mL, P<0.001]. ROC curve analysis showed that the area under the curve(AUC) was 0.928(95%CI: 0.886-0.969), and the cut-off value(Cut-off) of hs-cTnI was 0.339 ng/mL, corresponding sensitivity, specificity, positivity predictive value(PPV) and negative predictive value(NPV) were 88.3%, 96.3%, 92.1%, and 96.1%, respectively. Conclusion: The first hs-cTnI of POCT has good diagnostic efficiency for elderly AMI. The best cut-off value for early diagnosis of AMI in the elderly population in this region is 0.339 ng/mL, which has high accuracy and good operability in the differential diagnosis of AMI in the emergency department of the primary hospital.