The optimal rule-out strategy for acute myocardial infarction in chest pain patients with normal hs-cTnT
10.3969/j.issn.1006-5725.2018.01.015
- VernacularTitle:高敏肌钙蛋白T正常的胸痛患者早期排除急性心肌梗死的最佳策略
- Author:
Ying GUO
1
;
Wei LUO
;
Fei DING
;
Guixing LI
Author Information
1. 四川大学华西医院实验医学科
- Keywords:
acute myocardial infarction;
high-sensitivity troponin T(hs-cTnT);
5 h minus chest pain time
- From:
The Journal of Practical Medicine
2018;34(1):63-66
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of this study was to evaluate the diagnostic value of rule-out strategy for acute myocardial infarction (AMI) in chest pain patients with normal high-sensitivity troponin T (hs-cTnT).Methods Adults presenting chest pain to the West China hospital of Sichuan university from January 2016 to January 2017 were enrolled.Clinical data including ECG and hs-cTnT concentration was obtained.The diagnostic value of three strategies were evaluated.The optimal rule-out strategy for AMI were finally established in chest pain patients.Results A total of 153 patients were enrolled.In patients with chest pain time less than 5 h,the first hscTnT level was less than 14 ng/L.The negative predictive value (NPV) of 0/3 h dynamic observation and 5 minus the time of chest pain were 100％.The NPV was 99.8％ to rule-out AMI directly using the first hs-cTnT level.Conclusions For patients with chest pain time less than 5 h,the first hs-cTnT level less than 14 ng/L,0/3 h dynamic observation and the strategy of 5 h minus chest pain time have the same diagnosis value for ruling out AMI alternatively.It was not suggested to use the first hs-cTnT level to rule out AMI .
