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| 1 | 急性呼吸困难患者中白介素家族成员ST2的测定:PRIDE(急诊科呼吸困难患者脑利钠肽前体)研究的结果显示文摘目的:本研究旨在确定在呼吸困难患者中测定白介素-1受体家族成员ST2的价值。背景:据报道,心力衰竭(HF)患者中ST2浓度升高。方法:对593例就诊于市区急诊科的伴或不伴急性不稳定性HF的呼吸困难患者测定其ST2浓度。识别1年死亡的独立预测因素。 | Januzzi Jr. J.L. PeacockW.F. Maisel A.S. 黄欣 | 2007 | 世界核心医学期刊文摘(心脏病学分册)2007，，12： | 15 |
| 2 | N末端B型利钠肽前体测定可改善可疑急性心力衰竭患者的处理:加拿大前瞻性随机多中心IM-PROVE-CHF研究的初步结果显示文摘背景:N末端B型利钠肽前体(NT-proBNP)在心力衰竭中的诊断价值已得到确认。然而,大多数数据来自卫生医疗资源应用丰富的国家,而且尚缺乏有关NT-proBNP应用价值的随机研究证据。 | Moe G.W. Howlett J. Januzzi J.L. Zowall H. 杜媛 | 2007 | 世界核心医学期刊文摘(心脏病学分册)2007，，10： | 5 |
| 3 | N末端脑利钠肽前体处于中间浓度对急性心力衰竭诊断和预后的作用显示文摘Age-stratified cutpoints for aminoterminal pro-brain natriuretic peptide(NT-pro-BNP) concentrations are diagnostic in 83%of all subjects with acute dyspnea. This study analyzed subjects with NT-pro-BNP concentrations between the “rule-out”and “rule-in”cutpoints, the so-called natriuretic peptide gray zone. NT-pro-BNP concentrations, clinical characteristics, and 60-day mortality were studied in 1,256 acutely dyspneic patients from an international multicenter study. Of all subjects, 215 had gray-zone NT-pro-BNP concentrations, 116 of whom(54%) were diagnosed with heart failure(HF). Among these subjects, patients with HF were more likely to be older, to have a history of HF, to be in atrial fibrillation, and to have elevated troponin T concentrations compared with those without HF. In multivariate analysis, the use of loop diuretics on presentation(odds ratio[OR] 3.99, 95%confidence interval[CI] 1.58 to 10.1, p=0.003), paroxysmal nocturnal dyspnea(OR 4.50, 95%CI 1.31 to 15.4, p=0.02), jugular venous distention(OR 3.05, 95%CI 1.06 to 8.79, p=0.04), and the absence of cough(OR 0.18, 95%CI 0.06 to 0.52, p=0.001) were associated with a diagnosis of acute HF in gray-zone patients. Subjects with HF and diagnostically elevated NT-pro-BNP concentrations had the highest mortality rates, subjects without HF and NT-pro-BNP concentrations< 300 ng/L had the lowest mortality rates, and subjects with gray-zone NT-pro-BNP had intermediate outcomes, irrespective of their final diagnoses. Adding specific clinical information to NT-pro-BNP improves diagnostic accuracy in subjects with intermediate NT-pro-BNP concentrations. Mortality rates in subjects with intermediate NT-pro-BNP concentrations are lower than in those with NT-pro-BNP concentrations diagnostic for HF but are higher than in subjects with NT-pro-BNP concentrations less than the gray zone. | van Kimmenade R.R.J. Pinto Y.M. Bayes-Genis A. J.L. Januzzi Jr. 雷聪 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，，12： | 0 |
| 4 | 在最初血浆肌钙蛋白阴性的非ST段抬高型急性冠状动脉综合征患者中预测后期肌钙蛋白阳性:来自TIMI IIIB和GUSTO IIA研究的临床预测因素和已确定的风险评分结果显示文摘Background: Troponin testing is useful for evaluating patients with non- ST segment elevation acute coronary syndromes(NSTE ACS); however, a significant ercentage of patients are troponin negative at presentation and develop late rise of the marker. Methods: Patients in the TIMI IIIB study were assessed with respect to their troponin I(TnI) status at presentation and 12 hours. Multivariable analysis identified independent clinical factors associated with TnI rise at 12 hours among subjects initially TnI negative. A score predicting late TnI rise in TIMI IIIB was developed using these factors and validated among patients in the GUSTO IIA study. Results: Of 1342 subjects in TIMI IIIB, 200(14.9% ) were negative at baseline, but developed an elevated TnI(≥ 0.4 ng/mL) at 12 hours. Six independent predictors of late TnI rise were identified: ST- segment deviation(odds ratio [OR] 3.52, 95% CI 2.38- 5.23, P< .001), presentation< 8 hours from symptom onset(OR 2.91, 95% CI 1.92- 4.40, P< .001), no prior percutaneous coronary intervention(OR 2.88, 95% CI 1.54- 5.39, P=.001), no prior β - blocker use(OR 1.74, 95% CI 1.15- 2.63, P=.008), unheralded angina(OR 1.65, 95% CI 1.12- 2.42, P=.01), and a history of myocardial infarction(OR 1.59, 95% CI 1.06- 2.37, P=.02). ST deviation, presentation< 8 hours from symptoms, and no prior percutaneous coronary intervention were given a score of 2 points, whereas a score of 1 point was assigned to the other factors. Among baseline TnI- negative patients, a rising score was paralleled by an increasing prevalence of late TnI rise from 0% (with a score of 0) to 69% (with a score of 9)(P< .001). In confirmation, the score was able to similarly predict late troponin T rise among 855 patients in the GUSTO IIA study(P< .0001). Conclusion: Development of late troponin rise is common in non- ST- segment elevation acute coronary syndromes. Six easily ascertained variables may be used to identify those at higher risk for late rise in troponin levels after an initially negative presentation. | Januzzi Jr. J.L. Newby L.K. Murphy S.A. 孙凯 | 2006 | 世界核心医学期刊文摘(心脏病学分册)2006，2，6： | 0 |
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