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Clinica Chimica Acta：基于心肌肌钙蛋白-T谱图检测CABG后PMI的患者

2020-05-12 MedSci原创 MedSci原创

冠状动脉旁路移植术(CABG)；围手术期
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冠状动脉旁路移植术(CABG)后围手术期心肌梗死(PMI)的诊断具有复杂性，因为它主要基于心肌肌钙蛋白(cTn)的单一截止值，因此超过90%的CABG患者(包括非PMI患者)会超过这个值。

冠状动脉旁路移植术(CABG)后围手术期心肌梗死(PMI)的诊断具有复杂性，因为它主要基于心肌肌钙蛋白(cTn)的单一截止值，因此超过90%的CABG患者(包括非PMI患者)会超过这个值。在这项研究中，我们采用了一种无监督的统计建模方法来揭示冠脉搭桥术后临床相关的cTn释放特征，包括PMI，并以此来提高PMI的诊断准确性。

在624例接受CABG的患者中，在主动脉夹闭后24小时连续测量cTnT浓度。最终，有2857个cTnT测量值可用于拟合潜在类线性混合模型（LCMM）。

研究结果发现了四种类型，分别为:正常、高、低和升高的cTnT释放曲线。以PMI临床诊断为金标准，上升曲线的诊断准确率为97%，而最优选择的临界值为83%，指导建议的临界值为21%。

研究结果表明，可以使用连续测量的cTnT和LCMM来发现临床相关的亚组，包括PMI患者。 LCMM显示出卓越的PMI诊断准确性。 在诊断CABG后的PMI方面，升高cTnT曲线可能是比单个截止值更好的判据。

原始出处：

Ruben Deneer，Astrid.G.M. van Boxtel，Detecting patients with PMI post-CABG based on cardiac troponin-T profiles: A latent class mixed modeling approach

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1849928, encodeId=fdc918499286b, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Wed Jun 03 21:51:48 CST 2020, time=2020-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950297, encodeId=4c4b195029e89, content=<a href='/topic/show?id=2be01440862' target=_blank style='color:#2F92EE;'>#PMI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14408, encryptionId=2be01440862, topicName=PMI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sun Mar 14 02:51:48 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490336, encodeId=252d1490336ab, content=<a href='/topic/show?id=72a651322e0' target=_blank style='color:#2F92EE;'>#心肌肌钙蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51322, encryptionId=72a651322e0, topicName=心肌肌钙蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1de58724110, createdName=wrj0124, createdTime=Thu May 14 00:51:48 CST 2020, time=2020-05-14, status=1, ipAttribution=)]
    2020-06-03 windight

    #CTA#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1849928, encodeId=fdc918499286b, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Wed Jun 03 21:51:48 CST 2020, time=2020-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950297, encodeId=4c4b195029e89, content=<a href='/topic/show?id=2be01440862' target=_blank style='color:#2F92EE;'>#PMI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14408, encryptionId=2be01440862, topicName=PMI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sun Mar 14 02:51:48 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490336, encodeId=252d1490336ab, content=<a href='/topic/show?id=72a651322e0' target=_blank style='color:#2F92EE;'>#心肌肌钙蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51322, encryptionId=72a651322e0, topicName=心肌肌钙蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1de58724110, createdName=wrj0124, createdTime=Thu May 14 00:51:48 CST 2020, time=2020-05-14, status=1, ipAttribution=)]
    2021-03-14 doctorzheng

    #PMI#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1849928, encodeId=fdc918499286b, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Wed Jun 03 21:51:48 CST 2020, time=2020-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950297, encodeId=4c4b195029e89, content=<a href='/topic/show?id=2be01440862' target=_blank style='color:#2F92EE;'>#PMI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14408, encryptionId=2be01440862, topicName=PMI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sun Mar 14 02:51:48 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490336, encodeId=252d1490336ab, content=<a href='/topic/show?id=72a651322e0' target=_blank style='color:#2F92EE;'>#心肌肌钙蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51322, encryptionId=72a651322e0, topicName=心肌肌钙蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1de58724110, createdName=wrj0124, createdTime=Thu May 14 00:51:48 CST 2020, time=2020-05-14, status=1, ipAttribution=)]
    2020-05-14 wrj0124

    #心肌肌钙蛋白#

    0