高敏肌钙蛋白在检测和应用中的研究进展
|
摘要
针对高敏心肌肌钙蛋白(hs-cTn)检测的灵敏度得以提高而特异性不足的短板,现欧洲心脏病学会(ESC)指出高敏肌钙蛋白的基线水平结合动态模式,可减少由于特异性降低所致的误诊,使之能更准确地应用于急性冠状动脉综合征(ACS)的早期诊断、治疗决策和预后评估。同时,随着临床研究的深入和应用范围的扩大,hs-cTn在评估非ACS心脏病和非心源性疾病的风险与预后中也体现出重要的价值。越来越多的新发现和新观点不断涌现,打开了肌钙蛋白检测及临床解读的新局面。
For the short-board about increasing sensitivity and lack of specificity of hypersensitive cardiac troponin(hs-cTn),the European Society of Cardiology(ESC)now points out that the baseline level of highsensitivity troponin combined with dynamic mode can reduce the rate of misdiagnosis due to specificity reduction,then make it more accurate for early diagnosis,treatment decision-making and prognosis evaluation of acute coronary syndromes(ACS),which is one of the diagnostic criteria for myocardial infarction.With the deepening of clinical research and the expansion of application,hs-cTn is found as an important role in assessing the risk and prognosis of non-ACS heart disease and non-cardiac disease.As new discoveries and new ideas emerging,a new dimension of detection and interpretation of troponin is opened.
For the short-board about increasing sensitivity and lack of specificity of hypersensitive cardiac troponin(hs-cTn),the European Society of Cardiology(ESC)now points out that the baseline level of highsensitivity troponin combined with dynamic mode can reduce the rate of misdiagnosis due to specificity reduction,then make it more accurate for early diagnosis,treatment decision-making and prognosis evaluation of acute coronary syndromes(ACS),which is one of the diagnostic criteria for myocardial infarction.With the deepening of clinical research and the expansion of application,hs-cTn is found as an important role in assessing the risk and prognosis of non-ACS heart disease and non-cardiac disease.As new discoveries and new ideas emerging,a new dimension of detection and interpretation of troponin is opened.
引文
[1] SACCO R L,ROTH G A,REDDY K S,et al.The heart of 25by 25:Achieving the goal of reducing global and regional premature deaths from cardiovascular diseases and stroke:A modeling study from the american heart association and world heart federation[J].Circulation,2016,133(23):674-690.
[2]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》,概要[J].中国循环杂志,2018,33(1):1-8.
[3]吴金斌,邹德学,周逵,等.高敏肌钙蛋白T和普通肌钙蛋白I在急性心肌梗死早期诊断中的临床应用价值[J].国际检验医学杂志,2016,37(13):1799-1800.
[4] BOEDDINGHAUS J,TWERENBOLD R,NESTELBERGER T,et al.Clinical validation of a novel high-sensitivity cardiac troponin i assay for early diagnosis of acute myocardial infarction[J].Clin Chem,2018,64(9):1347-1360.
[5] AROONYADET N,JEAMSAKSIRI W,WISITSORAAT A,et al.Top-down and sensitive indium oxide nanoribbon field effect transistor biosensor chips integrated with onchip gate electrodes toward point of care applications[J].Nanotechnology,2018,29(40):405505.
[6] CAI Y,KANG K,LI Q,et al.Rapid and sensitive detection of cardiac troponin i for point-of-care tests based on red fluorescent microspheres[J].Molecules,2018,23(5):1102.
[7] LIU D,LU X,YANG Y,et al.A novel fluorescent aptasensor for the highly sensitive and selective detection of cardiac troponin I based on a graphene oxide platform[J].Anal Bioanal Chem,2018,410(18):4285-4291.
[8] Tan J W C,Lam C S P,Kasim S S,et al.Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis:focus on hs-TnI[J].Heart Asia,2017,9(1):81-87.
[9] AKSHAY B,ALEXANDER K P,JEFFERY B,et al.Use of troponin assay 99th percentile as the decision level for myocardial infarction diagnosis[J].Am Heart J,2017,190(1):135-139..
[10] GREENE D N,TATE J R.Establishing consensusbased,assay-specific 99th percentile upper reference limits to facilitate proper utilization of cardiac troponin measurements[J].Clin Chem Lab Med,2017,55(11):1675-1682.
[11]PETER H E,KOERBIN G,JULIA P M,et al.Statistical considerations for determining high-sensitivity cardiac troponin reference intervals[J].Clin Biochem,2017,50(9):502-505.
[12]APPLE F S,QUIST H E,DOYLE P J,et al.Plasma 99th percentile reference limits for cardiac troponin and creatine kinase MB mass for use with European Society of Cardiology/American College of Cardiology consensus recommendations[J].Clin Chem,2003,49(8):1331-1336.
[13]KELLER T,OJEDA F,ZELLER T,et al.Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac I assay[J].Int J Cardiol,2013,167(4):1423-1429.
[14]THYGESEN K,ALPERT J S,JAFFE A S,et al.Fourth universal definition of myocardial infarction(2018)[J].Rev Esp Cardiol(Engl Ed),2019,72(1):72.
[15]DALAL J J,PONDE C K,PINTO B,et al.Time to shift from contemporary to high-sensitivity cardiac troponin in diagnosis of acute coronary syndromes[J].Indian Heart J,2016,68(6):851-855.
[16]ZELLER T,OJEDA F,BRUNNER F J,et al.High-sensitivity cardiac troponin I in the general population-defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study[J].Clin Chem Lab Med,2015,53(5):699-706.
[17]SCHOFER N,BRUNNER F J,SCHLUTER M,et al.Gender-specific diagnostic performance of a new highsensitivity cardiac troponin I assay for detection of acute myocardial infarction[J].Eur Heart J Acute Cardiovasc Care,2017,6(1):60-68.
[18]LI M X,HWANG P M.Structure and function of cardiac troponin C(TNNC1):Implications for heart failure,cardiomyopathies,and troponin modulating drugs[J].Gene,2015,571(2):153-166.
[19]CHIN C W,SHAH A S,MCALLISTER D A,et al.High-sensitivity troponin I concentrations are a marker of an advanced hypertrophic response and adverse outcomes in patients with aortic stenosis[J].Eur Heart J,2014,35(34):2312-2321.
[20]MCCARTHY C P,DONNELLAN E,PHELAN D,et al.High sensitivity troponin and valvular heart disease[J].Trends Cardiovasc Med,2017,27(5):326-333.
[21] MCCARTHY C P,YOUSUF O,ALONSO A,et al.High-sensitivity troponin as a biomarker in heart rhythm disease[J].Am J Cardiol,2017,119(9):1407-1413.
[22]FILION K B,AGARWAL S K,BALLANTYNE C M,et al.Highsensitivity cardiac troponin T and the risk of incident atrial fibrillation:the Atherosclerosis Risk in Communities(ARIC)study[J].Am Heart J,2015,169(1):31-38.
[23]DEVEREAUX P J,BICCARD B M,SIGAMANI A,et al.Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery[J].JAMA,2017,317(16):1642-1651.
[24]BOSELLO S,DE LUCA G,BERARDI G,et al.Cardiac troponin T and NT-proBNP as diagnostic and prognostic biomarkers of primary cardiac involvement and disease severity in systemic sclerosis:A prospective study[J].Eur J Intern Med,2019,60(1):46-53.
[25]KAIER T E,TWERENBOLD R,PUELACHER C,et al.Direct comparison of cardiac myosin-binding protein C with cardiac troponins for the early diagnosis of acute myocardial infarction[J].Circulation,2017,136(16):1495-1508.
[2]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》,概要[J].中国循环杂志,2018,33(1):1-8.
[3]吴金斌,邹德学,周逵,等.高敏肌钙蛋白T和普通肌钙蛋白I在急性心肌梗死早期诊断中的临床应用价值[J].国际检验医学杂志,2016,37(13):1799-1800.
[4] BOEDDINGHAUS J,TWERENBOLD R,NESTELBERGER T,et al.Clinical validation of a novel high-sensitivity cardiac troponin i assay for early diagnosis of acute myocardial infarction[J].Clin Chem,2018,64(9):1347-1360.
[5] AROONYADET N,JEAMSAKSIRI W,WISITSORAAT A,et al.Top-down and sensitive indium oxide nanoribbon field effect transistor biosensor chips integrated with onchip gate electrodes toward point of care applications[J].Nanotechnology,2018,29(40):405505.
[6] CAI Y,KANG K,LI Q,et al.Rapid and sensitive detection of cardiac troponin i for point-of-care tests based on red fluorescent microspheres[J].Molecules,2018,23(5):1102.
[7] LIU D,LU X,YANG Y,et al.A novel fluorescent aptasensor for the highly sensitive and selective detection of cardiac troponin I based on a graphene oxide platform[J].Anal Bioanal Chem,2018,410(18):4285-4291.
[8] Tan J W C,Lam C S P,Kasim S S,et al.Asia-Pacific consensus statement on the optimal use of high-sensitivity troponin assays in acute coronary syndromes diagnosis:focus on hs-TnI[J].Heart Asia,2017,9(1):81-87.
[9] AKSHAY B,ALEXANDER K P,JEFFERY B,et al.Use of troponin assay 99th percentile as the decision level for myocardial infarction diagnosis[J].Am Heart J,2017,190(1):135-139..
[10] GREENE D N,TATE J R.Establishing consensusbased,assay-specific 99th percentile upper reference limits to facilitate proper utilization of cardiac troponin measurements[J].Clin Chem Lab Med,2017,55(11):1675-1682.
[11]PETER H E,KOERBIN G,JULIA P M,et al.Statistical considerations for determining high-sensitivity cardiac troponin reference intervals[J].Clin Biochem,2017,50(9):502-505.
[12]APPLE F S,QUIST H E,DOYLE P J,et al.Plasma 99th percentile reference limits for cardiac troponin and creatine kinase MB mass for use with European Society of Cardiology/American College of Cardiology consensus recommendations[J].Clin Chem,2003,49(8):1331-1336.
[13]KELLER T,OJEDA F,ZELLER T,et al.Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac I assay[J].Int J Cardiol,2013,167(4):1423-1429.
[14]THYGESEN K,ALPERT J S,JAFFE A S,et al.Fourth universal definition of myocardial infarction(2018)[J].Rev Esp Cardiol(Engl Ed),2019,72(1):72.
[15]DALAL J J,PONDE C K,PINTO B,et al.Time to shift from contemporary to high-sensitivity cardiac troponin in diagnosis of acute coronary syndromes[J].Indian Heart J,2016,68(6):851-855.
[16]ZELLER T,OJEDA F,BRUNNER F J,et al.High-sensitivity cardiac troponin I in the general population-defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study[J].Clin Chem Lab Med,2015,53(5):699-706.
[17]SCHOFER N,BRUNNER F J,SCHLUTER M,et al.Gender-specific diagnostic performance of a new highsensitivity cardiac troponin I assay for detection of acute myocardial infarction[J].Eur Heart J Acute Cardiovasc Care,2017,6(1):60-68.
[18]LI M X,HWANG P M.Structure and function of cardiac troponin C(TNNC1):Implications for heart failure,cardiomyopathies,and troponin modulating drugs[J].Gene,2015,571(2):153-166.
[19]CHIN C W,SHAH A S,MCALLISTER D A,et al.High-sensitivity troponin I concentrations are a marker of an advanced hypertrophic response and adverse outcomes in patients with aortic stenosis[J].Eur Heart J,2014,35(34):2312-2321.
[20]MCCARTHY C P,DONNELLAN E,PHELAN D,et al.High sensitivity troponin and valvular heart disease[J].Trends Cardiovasc Med,2017,27(5):326-333.
[21] MCCARTHY C P,YOUSUF O,ALONSO A,et al.High-sensitivity troponin as a biomarker in heart rhythm disease[J].Am J Cardiol,2017,119(9):1407-1413.
[22]FILION K B,AGARWAL S K,BALLANTYNE C M,et al.Highsensitivity cardiac troponin T and the risk of incident atrial fibrillation:the Atherosclerosis Risk in Communities(ARIC)study[J].Am Heart J,2015,169(1):31-38.
[23]DEVEREAUX P J,BICCARD B M,SIGAMANI A,et al.Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery[J].JAMA,2017,317(16):1642-1651.
[24]BOSELLO S,DE LUCA G,BERARDI G,et al.Cardiac troponin T and NT-proBNP as diagnostic and prognostic biomarkers of primary cardiac involvement and disease severity in systemic sclerosis:A prospective study[J].Eur J Intern Med,2019,60(1):46-53.
[25]KAIER T E,TWERENBOLD R,PUELACHER C,et al.Direct comparison of cardiac myosin-binding protein C with cardiac troponins for the early diagnosis of acute myocardial infarction[J].Circulation,2017,136(16):1495-1508.