Clinical Application Study Of High Sensitivity Cardiac Troponin Ⅰ In Cardiovascular Diseases

Objective Through the analysis of the detection results of high sensitivity cardiac troponin Ⅰ(Hs-cTnⅠ)in hospitalized patients in cardiovascular department,To explore and obtain the best diagnostic cut-off point of high sensitivity cardiac troponin Ⅰ for the diagnosis of Acute myocardial infarction(AMI).According to the best diagnostic cut-off point and the upper limit of noramal value,the concentration levels of high sensitivity cardiac troponin Ⅰ in different groups were analyzed.The causes of high sensitivity cardiac troponin Ⅰ elevation in non-myocardial infarction patients were further investigated.Methods The data of hospitalized patients in the Department of Cardiovascular medicine in our hospital from January 2021 to December 2021 were selected.receiver operator characteristic(ROC)curve analysis was performed according to the presence or absence of myocardial infarction,and the ROC curve was drawn to obtain the best diagnostic cut-off point of high sensiti vity cardiac troponin Ⅰ.Patients were divided into different disease groups according to their main discharge diagnosis.The characteristics of high sensitivity cardiac troponin Ⅰ in different disease groups were analyzed.The best diagnostic cut-off point and the upper limit of normal value wer e used as the standard to obtain the disease spectrum of high sensitivity cardiac troponin I positive in non-myocardial infarction patients.According to the disease spectrum,the reasons for the increase of high sensitivity troponin Ⅰ in non-myocardial infarction patients were further explored.Results A total of 1745 patients(980 males and 765 females)were collected and divided into AMI group(n=57)and non-myocardial infarction group(n=1688).The AUC value of ROC curve was 0.988(95%CI:0.980-0.996).The optimal diagnostic cut-off point was 0.067ug/L,the sensitivity was 0.947,and the specificity was 0.940.If the cut-off value was 0.026ug/L,the sensitivity was 1.000 and the specificity was 0.829.Taking the best diagnostic cut-off point(hs-cTnⅠ 0.067ug/L)as the reference,the disease spectrum of hs-cTnI positive in non-myocardial infarction group was mainly heart failure and cardiomyopathy.Taking the optimal diagnostic cut-off point(0.067ug/L)as the standard,the patients with heart failure were divided into higher than the optimal diagnostic cut-off point group and no higher than the optimal diagnostic cut-off point group,and the Logistic regression equation was constructed.The results showed that age was a statistically significant predictor of hs-cTnⅠ level higher than the diagnostic cut-off point in patients with heart failure(OR=1.073,95%C I 1.033-1.114,P<0.001).N-terminal pro-brain natriuretic peptide had a statistically significant effect on hs-cTnⅠ concentration higher than the diagnostic cut-off point in patients with heart failure(OR=1.001,95%CI 1.001-1.001,P<0.001).Low-density lipoprotein had statistical significance for hs-cTnⅠ concentration higher than the diagnostic cut-off point in patients with heart failure(OR=2.181,95%CI 1.226-3.877,P=0.008).Conclusion The best diagnostic cut-off point of high-sensitivity cardiac troponin Ⅰ for the diagnosis of acute myocardial infarction in our hospital was 0.067ug/L,with a sensiti vity of 0.947 and a specificity of 0.940.The disease spectrum of hs-cTnⅠpositive in non-myocardial infarction group was mainly heart failure and cardiomyopathy.Age,N-terminal pro-brain natriuretic peptide and low-density lipoprotein have statistical significance for hs-cTnⅠ concentration above the diagnostic cut-off point in patients with heart failure.