| ObjectivesAnalysis of disease spectrum of patients with positive high-sensitivity cardiac troponin I(hs-c Tn I) in Fujian provincial hospital. In order to provide retrospective investigation and analysis of data for the clinical work. MethodsData from 1017 patients who had been serial detection of hs-c Tn I in Fujian provincial hospital between August 2011 and November 2012, they were used to analysis the disease spectrum. Combined with the related clinical data, laboratory examination, clinical diagnosis and outcome, and statistics the disease characteristics of patients with positive hs-c Tn I. Compare the disease spectrum of patients with positive hs-c Tn I within different age, gender, seasons, kidney function, and the difference of patients with different degrees of hs-c Tn I level. Using logistic regression analysis of in-hospital death’s relationship with in-hospital death risk factors. Data was analyzed by SPSS 18.0. Results1. The proportion of of patients with positive hs-c Tn I in acute coronary syndrome(ACS) is 51.7%, 48.3% for non-ACS. The top five line disease spectrum of patients with positive hs-c Tn I include ST-segment elevation myocardial infarction(STEMI), arrhythmia, non-ST segment elevation myocardial infarction(NSTEMI), heart failure, and stable coronary heart disease; the propotion of them were 28.2%, 23.3%, 17.4%, 17.0%, and 10.4%.According to the sex, the top five line disease spectrum of different gender patients with positive hs-c Tn I were similar, respectively, stable coronary heart disease, heart failure, STEMI, arrhythmia, and NSTEMI.2. According to the age divided the patients with positive hs-c Tn I into four groups, the top five line disease spectrum were similar, respectively, stable coronary heart disease, heart failure, STEMI, arrhythmia, and NSTEMI, the portion of them were slightly different. The diseases of non-cardiovascular disease, also common in trauma, postoperative cardiopulmonary resuscitation, subarachnoid hemorrhage for people under 60 years old; people more than 60 years old, but also common in valvular heart disease, stroke, chronic renal insufficiency, gastrointestinal bleeding; sepsis are common in all ages.3. According to the estimated glomerular filtration rate(e GFR), divided the patients with positive hs-c Tn I into four groups, respectively, normal renal function group, mild renal insufficiency groups, moderate renal insufficiency group, and severe renal insufficiency group. The top five line disease spectrum for patients in normal renal function group, mild renal insufficiency group and moderate renal insufficiency group were stable coronary heart disease, STEMI, arrhythmia, NSTEMI, and heart failure, the portion of them were slightly different; the top five line disease spectrum for patients in severe renal insufficiency group were chronic renal failure, heart failure, stable coronary heart disease, arrhythmia, and NSTEMI.4. According to the 10 times of boundary value of hs-c Tn I, divided the patients with positive hs-c Tn I into four groups, respectively, mild elevated group, moderate elevated group, severe elevated group, very severe elevated group. STEMI, NSTEMI happened in up to moderate elevated group, and very severe elevated group only contains with them. The top five line disease spectrum in other three groups, stable coronary heart disease, chronic renal failure, and sepsis, only happened in under moderate elevated group; under severe elevated group contain arrhythmia, heart failure, and post-cardio surgical operation. The diseases of non-cardiovascular disease, gastrointestinal bleeding only happened in mild elevated group; and resurrection, trauma only happened in severe elevated group.5. The patients of positive hs-c Tn I with ACS in hospital mortality was 7.0%, non-ACS was 12.6%, differences between the two groups was statistically significant(P<0.05). Binary logistic regression analysis showed that the inpatient mortality risk of patiens with above moderate renal dysfunction group was 2.263 times than that of under mild renal insufficiency group(OR 2.263, P<0.05); and age, sex, hs-c Tn I, N-terminal pro-brain natriuretic peptide did not increase the ACS patients and non-ACS patients hospitalized mortality risk. ConclusionsThe top five line disease spectrum of patients with positive hs-c Tn I were STEMI, arrhythmia, NSTEMI, heart failure, and stable coronary heart disease; the propotion of ACS were 51.7%, and 48.3% for non-ACS; the hospitalized mortality of ACS were 7.0%, and 12.6% for non-ACS. |
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