科研之友
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摘要
Background. - High-sensitivity cardiac troponin is the most specific and sensitive biomarker of myocardial injury. However, no study has investigated whether the early concentration of high-sensitivity cardiac troponin is increased or is of value in predicting short-term prognosis in patients with type-A acute aortic dissection (MD) in the emergency department. @@@ Aims. - To measure the high-sensitivity cardiac troponin T (hs-TnT) concentration in patients with type-A MD upon hospital admission, and to assess its value in predicting short-term prognosis. @@@ Methods. - We enrolled consecutive patients with type-A AAD. Blood samples were collected on admission; hs-TnT concentrations were measured on the Elecsys 2010 system. High-sensitivity C-reactive protein (hs-CRP), D-dimer and other biochemical indicators were measured. Patients were divided into two groups according to hs-TnT concentration on admission (< or >= 0.014 ng/mL). @@@ Results. - More than half (61.2%) of the 103 included patients had an hs-TnT concentration >= 0.014 ng/mL. hs-TnT concentrations were significantly higher in those who died compared with survivors (0.292 +/- 0.516 vs. 0.069 +/- 0.154 ng/mL; P=0.003). Multivariable Cox regression analysis suggested that hs-TnT is an independent factor for predicting in-hospital mortality risk (odds ratio: 2.202, 95% confidence interval: 1.111-4.367; P=0.024). Kaplan-Meier curves revealed a significant increase in hospital mortality in the hs-TnT(+) group compared with the hs-TnT(-) group (P=0.021). When hs-TnT was >= 0.042 ng/mL, the sensitivity and specificity in predicting hospital short-term mortality were 70.8% and 76.4%, respectively. @@@ Conclusions. - Our study suggests that hs-TnT concentration could be used as an early biomarker for the risk stratification of patients with type-A AAD in the emergency department; the relationship between hs-TnT concentration and long-term prognosis needs further investigation.
