Diversity of the Elevation of Serum Cardiac Troponin I Levels in Patients During Their First Visit to the Emergency Room

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概要

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• Background Although measurement of serum creatine kinase levels, as well as myoglobin levels, has been used for screening patients with acute coronary syndrome (ACS), the specificity of both is low. Measurement of cardiac troponin levels is now extensively used for the diagnosis of ACS because of their superior cardiac specificity. However, troponin levels are reportedly elevated not only in patients with ACS but also in those with other diseases. Methods and Results The clinical characteristics of 1,023 patients (mean age: 63.5±16.3 years; males: 665, females: 358) whose serum cardiac troponin I (cTnI) levels had been measured at the initial visit to the emergency room of Toyota Memorial Hospital between April 2004 and March 2005 were retrospectively analyzed. A positive elevation of cTnI was defined as cTnI ≥ 0.03 ng/ml. There were 432 patients (42.2%) with positive cTnI levels. The cTnI levels (8.48±2.64ng/ml) in patients with acute myocardial infarction (AMI) were greater than those (0.25±0.07ng/ml) in patients with unstable angina pectoris (AP), as well as those (0.04±0.01ng/ml) in patients with stable AP. In terms of the diagnosis of AMI, the sensitivity was high enough (94.6%), but its specificity was relatively low (61.9%). Furthermore, the differentiation between AMI and unstable AP by the cTnI value alone was impossible. The cTnI levels were elevated in patients with a variety of diseases other than ACS, including heart failure, cardiomyopathies, myocarditis, renal failure, tachyarrhythmias, and pulmonary embolism. Conclusions Elevation of the cTnI level is frequently observed in patients in the emergency room with common diseases other than ACS.

• 社団法人日本循環器学会の論文
• 2007-08-20

著者

• KATO Yosuke

  Department of Cardiovascular Medicine, Faculty of Medicine, Tottori University

• Tomita Yasushi

  Division Of Integrated Medicine Toyota Memorial Hospital

• Nagata Kohzo

  Pathophysiological Laboratory Sciences, Graduate School of Medicine, Nagoya University

• Umeda Hisashi

  Division Of Cardiology Toyota Memorial Hospital

• Kato Yosuke

  Pathophysiological Laboratory Sciences Graduate School Of Medicine Nagoya University

• Kasai Yurie

  名古屋大学 医学系研究科生体生理解析学

• NAGATA Kohzo

  Nagoya University School of Health Sciences

• Nagata Kohzo

  名古屋大学 医学系研究科病態解析学

• Nagata Kohzo

  名古屋大学 医学系研究科医療技術科学専攻

• Nagata Kohzo

  名古屋大学 医学系研究科循環器ゲノム情報応用診断学

• KOIKE Yasuo

  Pathophysiological Laboratory Sciences, Graduate School of Medicine, Nagoya University

• Saiki Atsushi

  Department of Clinical Laboratory, Toyota Memorial Hospital

• Iwase Mitsunori

  Division of Integrated Medicine, Toyota Memorial Hospital

• Takeichi Yasushi

  Division of Integrated Medicine, Toyota Memorial Hospital

• Umeda Hisashi

  Department of Cardiology, Toyota Memorial Hospital

• Ishiki Ryouji

  Department of Cardiology, Toyota Memorial Hospital

• Inagaki Haruo

  Department of Cardiology, Toyota Memorial Hospital

• Nakamura Kae

  名古屋大学 循環病態探索医療学

• Iwase M

  Pathophysiological Laboratory Sciences Graduate School Of Medicine Nagoya University

• Kato Yuriko

  名古屋大学 医学系研究科生体生理解析学

• Ishiki Ryoji

  Division of Cardiology, Toyota Memorial Hospital

• Inagaki Haruo

  Division of Cardiology, Toyota Memorial Hospital

• Kodama Yasuhiro

  Pathophysiological Laboratory Sciences Graduate School Of Medicine Nagoya University

• Inagaki Haruo

  Division Of Cardiology Toyota Memorial Hospital

• Inagaki Haruo

  Department Of Cardiology Aichi Cardiovascular And Respiratory Center

• Iwase Mitsunori

  名古屋大学 医学系研究科医療技術科学専攻

• Katoh Yosuke

  Nagoya University School of Health Sciences

• Iwase Mitsunori

  Division Of Acute Coronary Syndrome Aichi Council Of Advanced Emergency Care

• Iwase Mitsunori

  School Of Health Sciences Nagoya University

• Nagata Kohzo

  Department Of Medical Technology Nagoya University School Of Health Sciences

• Inagaki Haruo

  From The Department Of Clinical Laboratory Nagoya University Hospital The First Department Of Intern

• Inagaki Haruo

  Dept. Of Clinical Laboratory Toyota Memorial Hospital

• Inagaki Haruo

  First Department Of Internal Medicine Nagoya University School Of Medicine

• Umeda Hisashi

  Aichi Prefectural Owari Hospital Cardiovascular Center

• Iwase Mitsunori

  Pathophysiological Laboratory Sciences Graduate School Of Medicine Nagoya University

• Ishiki Ryoji

  Division Of Cardiology Toyota Memorial Hospital

• Saiki Atsushi

  Department Of Clinical Laboratory Toyota Memorial Hospital

• Iwase Masatsugu

  Division Of Integrated Medicine Toyota Memorial Hospital

• Iwase Mitsunori

  Department Of Medical Technology Nagoya University School Of Health Sciences

• Koike Yasuo

  Pathophysiological Laboratory Sciences Graduate School Of Medicine Nagoya University

• Tatematsu Yasushi

  Division Of Integrated Medicine Toyota Memorial Hospital

• Nagata Kozo

  Graduate School Of Medicine Nagoya University

• Nagata Kohzo

  Department Of Medical Technology School Of Health Sciences Nagoya University

• SAIKI Atsushi

  Department of Aerospace Engineering, Tohoku University

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