BACKGROUND:The early diagnosis of acute myocardial infarction(AMI)remains challenging,especially for institutions without the high-sensitive cardiac troponin(hs-c Tn)assay.Herein,we aim to assess the value of creatine...BACKGROUND:The early diagnosis of acute myocardial infarction(AMI)remains challenging,especially for institutions without the high-sensitive cardiac troponin(hs-c Tn)assay.Herein,we aim to assess the value of creatine kinase-myocardial band isoenzyme(CK-MB)combined with different cardiac troponin(c Tn)assays in AMI diagnosis.METHODS:This multicenter,observational study included 3,706 patients with acute chest pain from September 1,2015,to September 30,2017.We classified the participants into three groups according to the c Tn assays:the point-of-care c Tn(POC-c Tn)group,the contemporary c Tn(c-c Tn)group,and hs-c Tn group.The diagnostic value was quantified using sensitivity and the area under the curve(AUC).RESULTS:Compared to the single POC-c Tn/c-c Tn assays,combining CK-MB and POC-c Tn/c-c Tn increased the diagnostic sensitivity of AMI(56.1%vs.63.9%,P<0.001;82.7%vs.84.3%,P=0.025).In contrast,combining CK-MB and hs-c Tn did not change the sensitivity compared with hs-c Tn alone(95.0%vs.95.0%,P>0.999).In the subgroup analysis,the sensitivity of combining CKMB and c-c Tn increased with time from symptom onset<6 h compared with c-c Tn alone(72.8%vs.75.0%,P=0.046),while the sensitivity did not increase with time from symptom onset>6 h(97.5%vs.98.3%,P=0.317).The AUC of the combination of CK-MB and POC-c Tn significantly increased compared to the single POC-c Tn assay(0.776 vs.0.750,P=0.002).The AUC of the combined CKMB and c-c Tn/hs-c Tn assays did not significantly decrease compared with that of the single c-c Tn/hs-c Tn assays within 6 h.CONCLUSIONS:The combination of CK-MB and POC-c Tn or c-c Tn may be valuable for the early diagnosis of AMI,especially when hs-c Tn is not available.展开更多
Background Acute myocardial infarction is a common and prevalent cardiovascular disease that can lead to serious consequences such as shock,arrhythmia,and heart failure.In dealing with acute myocardial infarction,the ...Background Acute myocardial infarction is a common and prevalent cardiovascular disease that can lead to serious consequences such as shock,arrhythmia,and heart failure.In dealing with acute myocardial infarction,the optimization of emergency nursing process can ensure the effectiveness and safety of rescue work,and help improve the prognosis and rehabilitation of patients.Methods 68 cases of patients with acute myocardial infarction admitted to our hospital from August 2021 to March 2023 were selected as the subjects of this study.They were randomly divided into an observation group and a control group,with 34 cases in each group.The control group received routine nursing care,while the observation group received optimized emergency nursing process based on it.the success rates of rescue,emergency efficiency,complications,and hemodynamics were compared between the two groups.ResultsThe success rate of rescue in the observation group was 100.00%,while in the control group it was 88.24%,the success rate of rescue was statistically different between the two groups(P<0.05).The observation group had shorter time intervals from onset to hospital admission,shorter door-to-activation time,shorter door-toballoon time,and reduced length of hospital stay compared to the control group(P<0.05).The total proportion of patients with complications such as arrhythmias in the observation group was 0.00%,while in the control group it was 11.76%,the difference between the two groups was statistically significant(P<0.05).The Cardi-ac output(CO)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is higher than the control group.The Mean arterial pressure(MAP)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is lower than the control group(P<0.05).Conclusions Optimized the emergency nursing process can improve the success rate of rescue and emergency efficiency in patients with acute myocardial infarction,reduce the occurrence of adverse complications,and improve negative emotions such as anxiety.It is worth promoting and applying.展开更多
基金This study was supported by grants from the National Key R&D Program of China (2017YFC0908700, 2017YFC0908703)National S&T Fundamental Resources Investigation Project (2018FY100600, 2018FY100602)+2 种基金Taishan Pandeng Scholar Program of Shandong Province (tspd20181220)Taishan Young Scholar Program of Shandong Province (tsqn20161065, tsqn201812129)Key R&D Program of Shandong Province (2020SFXGFY03, 2019GSF108073)
文摘BACKGROUND:The early diagnosis of acute myocardial infarction(AMI)remains challenging,especially for institutions without the high-sensitive cardiac troponin(hs-c Tn)assay.Herein,we aim to assess the value of creatine kinase-myocardial band isoenzyme(CK-MB)combined with different cardiac troponin(c Tn)assays in AMI diagnosis.METHODS:This multicenter,observational study included 3,706 patients with acute chest pain from September 1,2015,to September 30,2017.We classified the participants into three groups according to the c Tn assays:the point-of-care c Tn(POC-c Tn)group,the contemporary c Tn(c-c Tn)group,and hs-c Tn group.The diagnostic value was quantified using sensitivity and the area under the curve(AUC).RESULTS:Compared to the single POC-c Tn/c-c Tn assays,combining CK-MB and POC-c Tn/c-c Tn increased the diagnostic sensitivity of AMI(56.1%vs.63.9%,P<0.001;82.7%vs.84.3%,P=0.025).In contrast,combining CK-MB and hs-c Tn did not change the sensitivity compared with hs-c Tn alone(95.0%vs.95.0%,P>0.999).In the subgroup analysis,the sensitivity of combining CKMB and c-c Tn increased with time from symptom onset<6 h compared with c-c Tn alone(72.8%vs.75.0%,P=0.046),while the sensitivity did not increase with time from symptom onset>6 h(97.5%vs.98.3%,P=0.317).The AUC of the combination of CK-MB and POC-c Tn significantly increased compared to the single POC-c Tn assay(0.776 vs.0.750,P=0.002).The AUC of the combined CKMB and c-c Tn/hs-c Tn assays did not significantly decrease compared with that of the single c-c Tn/hs-c Tn assays within 6 h.CONCLUSIONS:The combination of CK-MB and POC-c Tn or c-c Tn may be valuable for the early diagnosis of AMI,especially when hs-c Tn is not available.
文摘Background Acute myocardial infarction is a common and prevalent cardiovascular disease that can lead to serious consequences such as shock,arrhythmia,and heart failure.In dealing with acute myocardial infarction,the optimization of emergency nursing process can ensure the effectiveness and safety of rescue work,and help improve the prognosis and rehabilitation of patients.Methods 68 cases of patients with acute myocardial infarction admitted to our hospital from August 2021 to March 2023 were selected as the subjects of this study.They were randomly divided into an observation group and a control group,with 34 cases in each group.The control group received routine nursing care,while the observation group received optimized emergency nursing process based on it.the success rates of rescue,emergency efficiency,complications,and hemodynamics were compared between the two groups.ResultsThe success rate of rescue in the observation group was 100.00%,while in the control group it was 88.24%,the success rate of rescue was statistically different between the two groups(P<0.05).The observation group had shorter time intervals from onset to hospital admission,shorter door-to-activation time,shorter door-toballoon time,and reduced length of hospital stay compared to the control group(P<0.05).The total proportion of patients with complications such as arrhythmias in the observation group was 0.00%,while in the control group it was 11.76%,the difference between the two groups was statistically significant(P<0.05).The Cardi-ac output(CO)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is higher than the control group.The Mean arterial pressure(MAP)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is lower than the control group(P<0.05).Conclusions Optimized the emergency nursing process can improve the success rate of rescue and emergency efficiency in patients with acute myocardial infarction,reduce the occurrence of adverse complications,and improve negative emotions such as anxiety.It is worth promoting and applying.
