High-sensitivity cardiac troponin (hs-cTn) assays have been used clinically by thousands of physicians in many countries throughout the world since their clinical introduction 7 years ago. In the early diagnosis of myocardial infarction (MI), beyond doubt, the most important indication of hs-cTn assays, these simple, inexpensive, and highly reproducible tools complement detailed clinical assessment including chest pain characteristics and the electrocardiogram. Hs-cTn assays for the first time allowed the precise quantification of cardiomyocyte injury around the 99th percentile and thereby substantially increased the accuracy of MI detection from blood obtained at presentation to the emergency department (ED). Higher accuracy at ED presentation enabled the development and extensive validation of early hs-cTn-based diagnostic algorithms, which substantially reduced the time required for the safe rule-out or rule-in of MI. This review summarizes key principles underlying the safe and effective use of hs-cTn in the ED in patients with suspected MI.

中文翻译：

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高敏心肌肌钙蛋白在疑似心肌梗死患者中的临床应用

自 7 年前临床引入以来，高灵敏度心肌肌钙蛋白 (hs-cTn) 检测已被全球许多国家的数千名医生临床使用。在心肌梗塞 (MI) 的早期诊断中，毫无疑问是 hs-cTn 检测最重要的指征，这些简单、廉价且高度可重复的工具补充了详细的临床评估，包括胸痛特征和心电图。Hs-cTn 检测首次允许在第 99 个百分位附近对心肌细胞损伤进行精确量化，从而大大提高了从向急诊科 (ED) 就诊时获得的血液中检测 MI 的准确性。ED 演示的更高准确性使基于 hs-cTn 的早期诊断算法的开发和广泛验证成为可能，这大大减少了安全排除或排除 MI 所需的时间。本综述总结了疑似 MI 患者在急诊部安全有效使用 hs-cTn 的关键原则。