In the past few years, many have disputed the optimal biomarker for confirming or ruling out a diagnosis of periprocedural myocardial infarction (PMI) and the optimal cut-off concentrations to apply. In this issue of the Journal of Cardiac Surgery, Niclauss et al. performed a retrospective analysis of CK-MB and high-sensitivity cardiac troponin T (hs-cTnT) dynamics and peak concentrations following different cardiac surgical interventions in 400 patients during a 2-year period in a single center. The authors found that CK-MB and hs-cTnT predict PMI with a comparable diagnostic accuracy and discriminatory power >95%. They also attempted to propose an improved, more sensitive threshold of hs-cTnT for PMI. Their findings could have implications for clinical practice, but more research is warranted to identify more appropriate cut-offs. This could include hs-cTnT release pattern, slope steepness, and changes. Ultimately, this could results in patient-specific model, able to predict expected and abnormal ranges of hs-cTnT release, enabling an improved and timely diagnosis of PMI.

中文翻译：

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改进围手术期心肌梗死的定义：高敏心肌肌钙蛋白的作用

在过去的几年中，许多人对用于确认或排除围手术期心肌梗死 (PMI) 诊断的最佳生物标志物以及应用的最佳截止浓度存在争议。在本期《心脏外科杂志》上, Niclauss 等人。在一个中心的 2 年内，对 400 名患者进行不同心脏手术干预后的 CK-MB 和高敏心肌肌钙蛋白 T (hs-cTnT) 动力学和峰值浓度进行了回顾性分析。作者发现 CK-MB 和 hs-cTnT 预测 PMI 具有相当的诊断准确性和 > 95% 的辨别力。他们还试图为 PMI 提出一种改进的、更敏感的 hs-cTnT 阈值。他们的发现可能对临床实践产生影响，但需要更多的研究来确定更合适的临界值。这可能包括 hs-cTnT 释放模式、坡度和变化。最终，这可能会产生特定于患者的模型，能够预测 hs-cTnT 释放的预期和异常范围，从而改进和及时诊断 PMI。