Impact of the Revised Criteria for Acute Myocardial Infarction Using Cardiac Troponins in a Japanese Population With Acute Coronary Syndromes
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概要
- 論文の詳細を見る
Background The clinical implications of applying the new criteria of acute myocardial infarction (AMI) with cardiac troponins in terms of their diagnostic and prognostic impact in patients with suspected acute coronary syndromes (ACS) have not been well evaluated. Methods and Results The study group comprised 973 consecutive patients who were diagnosed as having ACS with or without ST elevation (STE). They were divided into 3 groups: unstable angina (UA) group (n=195) representing patients with no significant elevations of creatine kinase (CK) and troponin T (TnT); TnT-myocardial infarction (MI) group (n=170) with TnT elevation and no CK elevation (additionally detected AMI by the new criteria); CK-MI group (n=608) with significant elevation of CK (AMI by the old criteria). In the TnT-MI group, 140 (76%) patients had non-STE ACS. In-hospital mortality rates for STE ACS were 0%, 2.5% and 9.7% in the UA, TnT-MI and CK-MI groups, respectively. The corresponding values for non-STE ACS were 1.8%, 4.6%, and 16.5%, respectively (p<0.0001), suggesting a pivotal role of TnT. In multiple logistic regression analysis, significant CK elevation was selected as an independent predictor of in-hospital death in concurrence with age≥75 years, prior MI, shock and low left ventricular ejection fraction in non-STE ACS. Conclusions The new criteria result in a substantial increase in the diagnosis of AMI from non-STE ACS in particular. They assist greatly in detailed risk stratification of ACS patients, notably in cooperation with the old CK criteria.
- 社団法人日本循環器学会の論文
- 2005-06-20
著者
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SATO Naoki
Intensive and Cardiac Care Unit, Nippon Medical School
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Yasutake Masahiro
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Yanagisawa Masao
Department Of Internal Medicine Division Of Cardiology Nippon Medical School Tama-nagayama Hosipital
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Takagi Hiromichi
Department Of Medical Information Science Osaka University Graduate School Of Medicine
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Yajima Toshimi
The Cardiovascular Institute Department Of Medicine Keio University School Of Medicine
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Takano T
Intensive & Cardiac Care Unit Nippon Medical School
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Kusama Yoshiki
Department Of Internal Medicine And Cardiology Tama-nagayama Hospital Nippon Medical School
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Kusama Yoshiki
First Department of Internal Medicine, Nippon Medical School
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Takayama Morimasa
Tokyo Ccu Network Scientific Committee:sakakibara Heart Institute
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Yamamoto Takeshi
Intensive and Cardiac Care Unit, Nippon Medical School
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Tanaka Keiji
Intensive and Cardiac Care Unit, Nippon Medical School
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Takano Teruo
First Department of Internal Medicine, Nippon Medical School
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Takano Teruo
Tokyo CCU network Scientific Committee
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Takano Teruo
日本医科大学附属第二病院 健康管理科
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Yasutake Masahiro
First Department of Internal Medicine, Nippon Medical School
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Takagi Hiromichi
Intensive and Coronary Care Unit, Nippon Medical School
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Akutsu Koichi
Intensive and Coronary Care Unit, Nippon Medical School
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Fujita Nobuhiko
Intensive and Coronary Care Unit, Nippon Medical School
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Kasagami Yasuhira
Intensive and Coronary Care Unit, Main Hospital, Nippon Medical School
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Takayama Morimasa
First Department of Internal Medicine, Nippon Medical School
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Akutsu Koichi
Tokyo Ccu Network Scientific Comittee Nippon Medical School
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Fujita Nobuhiko
Divisions Of Cardiology Hepatology Geriatrics And Integrated Medicine Department Of Internal Medicin
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Kasagami Yasuhira
Coronary Care Unit Nippon Medical School
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Kumazaki T
Department Of Radiology Center For Advanced Medical Technology Nippon Medical School
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Kijima T
Department Of Cardiology Tokyo Women's Medical University
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Kawara Tokuhiro
心臓血管研究所
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Takayama Morimasa
Sakakibara Heart Institute
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Takizaki Kohei
東京女子医科大学 循環器内科学
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Sato Naoki
Intensive And Cardiac Care Unit Nippon Medical School
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Takano Teruo
Division Of Cardiology Hepatology Geriatrics And Integrated Medicine Department Of Internal Medicine
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Kusama Yoshiki
Department Of Internal Medicine And Cardiology Nippon Medical School Tama-nagayama Hospital
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Kato Takeshi
The First Department Of Internal Medicine Nippon Medical School
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Takano Teruo
Intensive & Cardiac Care Unit Nippon Medical School
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Takano Teruo
First Department Of Internal Medicine Nippon Medical School
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Nakagomi Akihiro
First Department of Internal Medicine, Nippon Medical School Hospital
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Miyatake Yoshiko
First Department Of Internal Medicine Nippon Medical School
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Yanagisawa Masao
Department Of Internal Medicine Division Of Cardiology Nippon Medical School
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Kusama Yoshiki
First Department Of Internal Medicine Nippon Medical School
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Nakagomi Akihiro
Department Of Cardiology Tama-nagayama Hospital Nippon Medical School
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Fujita Nobuhiko
Department Of Medicine Nippon Medical School
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Takano Teruo
Department Of Lnternal Medicine Nippon Medical School
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Tanaka Keiji
Intensive And Cardiac Care Unit Nippon Medical School
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Takayama Morimasa
Tokyo Coronary Care Network
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Kusama Yoshiki
Nippon Medical School
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Taniguchi Hiroshi
Department Of Internal Medicine Division Of Cardiology Nippon Medical School
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Taniguchi Hiroshi
The First Departement Of Internal Medicine Nippon Medical School
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Nakagomi Akihiro
First Department Of Internal Medicine Nippon Medical School
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Kusama Yoshiki
Department Of Internal Medicine Nippon Medical School
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Yamashita Takeshi
Division Of Cardiology Department Of Medicine Nippon Medical School
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Takano Teruo
Department Of Internal Medicine (division Of Cardiology Hepatology Geriatrics And Integrated Medicin
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Fujita Nobuhiko
Divisions Of Cardiology Hepatology Geriatrics And Integrated Medicine Department Of Internal Medicin
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Yanagisawa Masao
Department Of Cardiology Nippon Medical School
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TAKANO Hitoshi
Nippon Medical School
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Takahashi Yasuhiro
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Kasagami Yasuhira
Intensive and Coronary Care Unit
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Akutsu Koichi
Intensive and Cardiac Care Unit, Nippon Medical School Hospital
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