SEE PAGE 2226 O ver the course of >2 decades, investigations have established cardiac troponin (cTn) as the core marker for diagnosing myocardial infarction (MI) (1,2). Successive generations of more sensitive assays have enabled the reliable detection of myocardial injury at increasingly lower concentrations. The arrival of high-sensitivity cTn (hs-cTn) in the clinical setting has provided great benefit, particularly for its negative predictive value in terms of more rapidly and confidently excluding acute myocardial injury. Coupled with dynamic changes over time, clinicians have greater ability to identify acute conditions earlier (3–6). The use of hs-cTn, however, has also posed significant challenges for clinicians because elevated concentrations are frequently detected in diverse clinical settings and have a variety of causes, including supplydemand mismatch, structural heart disease, inflammation, and others. As a result, increasing numbers of patients are found to have stable, low-level elevations or measurable values between the limit of detection and the upper reference limit. How to interpret these findings has been a challenge for clinicians, and it is in this setting that the analysis by Roos et al. (7) in this issue of the Journal provides important information. Beyond its diagnostic utility, cTn has repeatedly been shown to be a potent prognostic marker, particularly of cardiovascular death and heart

中文翻译：

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急诊科高敏肌钙蛋白新策略的时候到了*

参见第 2226 页 在超过 2 个十年的过程中，研究已将心肌肌钙蛋白 (cTn) 确定为诊断心肌梗塞 (MI) 的核心标志物 (1,2)。连续几代更灵敏的检测方法已经能够在越来越低的浓度下可靠地检测心肌损伤。高灵敏度 cTn (hs-cTn) 在临床环境中的出现提供了巨大的好处，特别是它在更快速和更自信地排除急性心肌损伤方面的阴性预测价值。再加上随时间的动态变化，临床医生更有能力更早地识别急性疾病 (3-6)。然而，hs-cTn 的使用也给临床医生带来了重大挑战，因为在不同的临床环境中经常检测到浓度升高并且有多种原因，包括供需不匹配、结构性心脏病、炎症等。结果，越来越多的患者被发现在检测限和参考上限之间具有稳定的低水平升高或可测量值。如何解释这些发现一直是临床医生面临的挑战，Roos 等人的分析正是在这种情况下进行的。(7) 在本期期刊中提供了重要信息。除了其诊断效用外，cTn 一再被证明是一种有效的预后标志物，尤其是心血管死亡和心脏疾病的预后标志物。如何解释这些发现一直是临床医生面临的挑战，Roos 等人的分析正是在这种情况下进行的。(7) 在本期期刊中提供了重要信息。除了其诊断效用外，cTn 一再被证明是一种有效的预后标志物，尤其是心血管死亡和心脏疾病的预后标志物。如何解释这些发现一直是临床医生面临的挑战，Roos 等人的分析正是在这种情况下进行的。(7) 在本期期刊中提供了重要信息。除了其诊断效用外，cTn 一再被证明是一种有效的预后标志物，尤其是心血管死亡和心脏疾病的预后标志物。