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急性冠脉综合征

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Revision: prognostic impact of baseline glucose levels in acute myocardial infarction complicated by cardiogenic shock-a substudy of the IABP-SHOCK II-trial Wearable Cardioverter-Defibrillator after Myocardial Infarction Impact of the US Food and Drug Administration–Approved Sex-Specific Cutoff Values for High-Sensitivity Cardiac Troponin T to Diagnose Myocardial Infarction Long-Term Coronary Functional Assessment of the Infarct-Related Artery Treated With Everolimus-Eluting Bioresorbable Scaffolds or Everolimus-Eluting Metallic Stents: Insights of the TROFI II Trial High-Sensitivity Troponin I Levels and Coronary Artery Disease Severity, Progression, and Long-Term Outcomes What's new in the Fourth Universal Definition of Myocardial infarction? Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial Application of High-Sensitivity Troponin in Suspected Myocardial Infarction The Potential Use of the Index of Microcirculatory Resistance to Guide Stratification of Patients for Adjunctive Therapy in Acute Myocardial Infarction Systems of Care for ST-Segment–Elevation Myocardial Infarction: A Policy Statement From the American Heart Association
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Expert Opinion2019 Feb 16. [Epub ahead of print]

JOURNAL：J Am Coll Cardiol. Article Link

Recommendations for Institutions Transitioning to High-Sensitivity Troponin Testing JACC Scientific Expert Panel

Januzzi JL Jr, Mahler SA, Christenson RH et al. Keywords: laboratory testing; myocardial infarction; troponin

ABSTRACT

High-sensitivity cardiac troponin (hs-cTn) I or T methods have been in use in certain regions for years but are now increasingly globally adopted, including in the United States. Accordingly, inevitable challenges are created for institutions transitioning from conventional cardiac troponin (cTn) assays. hs-cTn assays have higher analytic precision at lower concentrations, yielding greater clinical sensitivity for myocardial injury and allowing accurate recognition of small changes in troponin concentration (rise or fall) within a short time frame. Although much of the knowledge regarding troponin biology that was applicable with older troponin assays still holds true, considerable education regarding the differences between conventional cTn and hs-cTn is needed before medical systems convert to the newer methods. This includes a basic understanding of how hs-cTn testing differs from conventional cTn testing and how it is best deployed in different settings, such as the emergency department and inpatient services. This Expert Panel will review important concepts for institutional transition to hs-cTn methodology, providing recommendations useful for education before implementation.


Copyright ? 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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