Cardiac troponin I in the diagnosis of myocardial injury and infarction

被引:109
作者
Mair, J
Genser, N
Morandell, D
Maier, J
Mair, P
Lechleitner, P
Calzolari, C
Larue, C
Ambach, E
Dienstl, F
Pau, B
Puschendorf, B
机构
[1] UNIV INNSBRUCK, SCH MED, DEPT MED CHEM, A-6020 INNSBRUCK, AUSTRIA
[2] UNIV INNSBRUCK, SCH MED, DEPT BIOCHEM, A-6020 INNSBRUCK, AUSTRIA
[3] UNIV INNSBRUCK, SCH MED, DEPT INTERNAL MED, A-6020 INNSBRUCK, AUSTRIA
[4] UNIV INNSBRUCK, SCH MED, DEPT ANAESTHESIA & INTENS CARE MED, A-6020 INNSBRUCK, AUSTRIA
[5] UNIV INNSBRUCK, SCH MED, DEPT FORENS MED, A-6020 INNSBRUCK, AUSTRIA
[6] SANOFI RECH, CTR MONTPELLIER, F-34184 MONTPELLIER 04, FRANCE
[7] UNIV MONTPELLIER 2, CNRS UMR 9921, F-34060 MONTPELLIER 01, FRANCE
关键词
cardiac troponin I; cardiac troponin T; creatine kinase MB; myoglobin; myocardial injury; myocardial infarction;
D O I
10.1016/0009-8981(95)06168-1
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
We used a cardiospecific enzymoimmunometric assay to measure cardiac troponin I (cTnI) in samples serially drawn from 78 patients with acute myocardial infarction (AMI), 7 patients with unstable angina (Braunwald class III), 22 multi-traumatized patients, and in 30 athletes after eccentric exercise, as well as in 101 non-traumatic chest pain patients on admission to the emergency department, cTnI assay crossreactivity with crude human skeletal muscle homogenates was <0.1%. cTnI could not be detected in athletes or multi-traumatized patients except for 2 trauma patients with myocardial damage. increased cTnI concentrations were found in 6 of 7 patients with unstable angina at rest and in all AMI patients. After AMI, cTnI increased about 3.5 h (median) after the onset of chest pain, reached peak values parallel to CKMB, and stayed increased for at least 4 days, Cardiac troponin T (cTnT) increased and mostly peaked parallel to cTnI, cTnT sensitivity on the 7th day after AMI was significantly higher than that of cTnI. In contrast to cTnI, cTnT mostly showed a second, usually smaller, peak about day 4 after AMI. During the first 4 h after the onset of chest pain and before thrombolytic therapy the sensitivities of myoglobin (0.43) and CKMB mass (0.56) were significantly higher than those of both troponins (cTnI, 0.29; cTnT, 0.25). Areas under receiver operator characteristic curves indicated only moderate diagnostic accuracies of biochemical markers for early AMI diagnosis in non-traumatic chest pain patients on admission, with CKMB mass showing the highest value (0.76). Our results demonstrate that cTnI is a highly sensitive and specific marker for myocardial damage which is suitable for early and late diagnosis.
引用
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页码:19 / 38
页数:20
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