Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya3367710.26442/00403660.2019.09.000139Editorial articleПередовая статьяReview ArticleThe importance of modern high - sensitivity troponin tests in the diagnosis of myocardial infarction without ST-segment elevationЗначение современных высокочувствительных тестов на тропонин в диагностике инфаркта миокарда без подъема сегмента STAbaturovaO VАбатуроваОльга Викторовна

д.м.н., проф. каф. кардиологии и кардиохирургии с курсом скорой медицинской помощи ФГБОУ ВО «Тюменский ГМУ» Минздрава России

SuplotovS NСуплотовСергей Николаевич

д.м.н., проф., каф. акушерства, гинекологии и реаниматологии с курсом клинико-лабораторной диагностики ИНПР ФГБОУ ВО «Тюменский ГМУ» Минздрава России

KremnevaL VКремневаЛюдмила Викторовна

д.м.н., проф. каф. акушерства, гинекологии и реаниматологии с курсом клинико-лабораторной диагностики ИНПР ФГБОУ ВО «Тюменский ГМУ» Минздрава России

KremnevaLV01@gmail.comShalaevS VШалаевСергей Васильевич

д.м.н., проф., зав. каф. кардиологии и кардиохирургии с курсом скорой медицинской помощи ФГБОУ ВО «Тюменский ГМУ» Минздрава России

Tyumen Medical UniversityФГБОУ ВО «Тюменский государственный медицинский университет» Минздрава России15092019919VOL 91, NO9 (2019)ТОМ 91, №9 (2019)13714416042020Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/33677

The literature review presents the characteristics of modern high - sensitivity tests for detection of Tn (hs - cTn) in the blood and the results of large studies on the diagnosis of non segment elevation myocardial infarction (nonSTEMI) using hs - cTn. The results of these studies served as the basis for the development of three - and one - hour diagnostic algorithms nonSTEMI, presented in the recommendations of the European Society of Cardiology 2012 and 2015 and also in fourth Universal Definition of Myocardial Infarction 2018.

В обзоре литературы представлена характеристика современных высокочувствительных тестов для выявления тропонина [Тn (hs - cTn)] в крови, изложены результаты крупных исследований по диагностике инфаркта миокарда (ИМ) без подъема сегмента ST (ИМбпST) c использованием hs - cTn. Результаты этих исследований послужили основой для разработки трех - и одночасового алгоритмов диагностики ИМбпST, представленных в рекомендациях Европейского общества кардиологов 2012 и 2015 гг., а также в 4-м Универсальном определении ИМ 2018 г.

high sensitivity troponinnonSTEMIвысокочувствительные тропониновые тестыдиагностика инфаркт миокарда без подъема сегмента STThe Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined of Cardiology Committee. Myocardial infarction redefined - A consensus document of the Joint European Society of Cardiology. American College of Cardiology Committee for the Redefinition of Myocardial Infarction. Eur Heart J. 2000;21:1502-13. doi: 10.1053/eurj.2000.23052017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2017; 00:1-66. doi: 10.1093/eurheartj/ehx393Thygesen K, Alpert J.S, White H.D. On behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction Universal definition of Myocardial Infarction. Eur Heart J. 2008;29:9:1209-10. doi: 10.1093/eurheartj/ehn131Dhoot G.K, Frearson N, Perry S.V. Polymorphic forms of troponin T and Troponin C and their localization in Striated muscle cell types. Exp Cell Res. 1979;122(2):339-50. doi:10.1016/00 14- 4827(79)90310-0Remppis A. Intracellular compartmentation of troponin T: release kinetics after global ischemia and calcium paradox in the isolated perfused rat heart. J Mol Cell Cardiol. 1995;27(2):793-803. doi: 10.10 16/0022-2828(95)90086-1Mills N.L. Implementation of a sensitive troponin I assay and risk of recurrent myocardial infarction and death in patients with suspected acute coronary syndrome. JAMA. 2011;305(12):1210-6. doi: 10.1001/jama.20 11.338Mills N.L, Lee K.K, Mc Allister D.A, et al. Implications of lowering threshold of plasma troponin concentration in cohort study. BMI. 2012;344:1533-44. doi: 10.1136/bmj.e1533Lipinski M.J, Baker N.C, Escárcega R.O, et al. Comparison of conventional and high - sensitivity troponin in patients with chest pain: a collaborative meta - analysis. Am Heart J. 2015;169:1:6-16. doi: 10.1016/j.ahj: 2014.10.007Giannitsis E, Kurz K, Hallermayer K, et al. Analytical validation of high - sensitivity cardiac troponin T assay. Clin Chem. 2010;56:254-61. doi: 10.1373/ clinchem.2009.132654Apple F.S. A new season for cardiac troponin assay: troponin assay: its time to keep a scorerard. Clin Chem. 2009;55:1303-06. doi:10.1373/ clinchem.2009.128363Hickman P.E, Potter J.M, Aroney C, et al. Cardiac troponin may be released by ischemia alone, without necrosis. Clin Chim Acta. 2010;411:318-23. doi: 10.1016/j.cca.2009.12.09Jaffe A.S, Wu A.H.B. Troponin Release - Reversible or Irreversible Injury? Should We Care? Clinical Chemistry. 2011;58(1):148-50. doi: 10.1373/ clinchem.2011.173070Кремнева Л.В., Суплотов С.Н., Шалаев С.В. Оценка высокочувствительных тестов на тропонин в диагностике острого коронарного синдрома. Рациональная фармакотерапия в кардиологии. 2016;12(2):204-9. doi: 10.20996/1819-6446-2016-12-2-204-209Mueller M, Vafaie M, Biener M. Cardiac troponin T. Circ J. 2013;77(7):1653-61. doi: 10.1253/circj.cj-13-0706Gaze D.C, Collinson P.O. Multiple molecular forms of circulating cardiac troponin: analytical and clinical significance. Ann Clin Biochem. 2008;45:4:349-55. doi: 10.1258/acb.2007.007229Apple F.S. Standartization of Cardiac Troponin I Assay. Will Not Occur in My Lifetime. Clin Chem. 2011;58:169-71. doi: 10.1373/clinchem.2011. 166-5.Jobs A, Thiele H. ESC guidelines 2015: Non-ST elevation acut coronary syndrome. Herz. 2015;40(8):1027-33. doi: 10.1007/s00059-015-4369-1Lippi G, Montagnana M, Aloe R, Cervellin G. High sensitive troponin immunoassays: navigating between the scylla and charybdis. Adv Clin Chem. 2012;58:1-29. doi: 10.1016.b978-0-12-394383-5.00007-2De Lemos J.A. Increasingly sensitive assays for cardiac troponins. JAMA. 2013;309(21):2262-9. doi: 10.1001/jama.2013.5809Marini M.G, Cadillo M.T, Caroli A. Increasing specifity of high - sensitivity troponin: New approaches and perspectives in the diagnosis of acute coronary syndromes. J Cardiol. 2013;62:4:205-9. doi:10.1016/j-jjcc.2013.04.005Thygesen K, Alpert J.S, Jaffe A.S, et al. Third Universal Definition of Myocardial Infarction. Circulation. 2012;126(16):2020-35. doi: 10.1161/cir.0b013e31826e1058Thygesen K, Mair I, Giannitsis E, et al. How to Use High-Sensitivity. Cardiac Troponins in Acute Cardiac Care. Eur Heart J. 2012;33(18):2252-7. doi: 10.1093/eurheartj/ehs154Reichlin T, Twerenbold R, Wildi K, et al. Prospective validation of a 1-hour algorithm to rule - out and rule - in acute myocardial infarction using a high - sensitivity cardiac troponin T assay. CMAJ. 2015:187:243-52. doi: 10.1503/cmaj.141349Druey S, Wildi R, Twerenbold R, et al. Early rule - out and rule - in of myocardial infarction using sensitive cardiac troponin I. Int J Cardiol. 2015;195:163-70. doi: 10.1016/j.ijcard.2015.05.079Hoeller R, Gimenez M. Normal presenting levels of highsensitivity ponin and myocardial infarction. Heart. 2013;99(21):1567-72. doi: 10.1136/heartjnl-2013-303643Carlton E, Greenslade J, Cullen L, et al. Evaluation of high - sensitivy cardiac troponin I level in suspected acute coronary syndrome. JAMA Cardiol. 2016;1(4):405-12.Neumann J.T, Sörensen N.A, Schwemer T, et al. Diagnosis of Myo car dial Infarction Using a High- Sensitivity Troponin I 1-Hour Algorithm. JAMA Cardiol. 2016;1(4):397-404. doi: 10.1001/jamacardio.20160695Than M, Cullen Z, Aldous S, et al. 2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker: The ADAPT trial. J Am Coll Cardiol. 2012;59(23):2091-8 doi:10.1016/j.jacc.2012.02.035Rubini G.M, Twerenbold R, Jaeger C, et al. One - hour rule - in and rule - out of acute myocardial infarction using high - sensitivity cardiac troponin. Am J Med. 2015;128:861-70. doi: 10.1016/j.amjmed.2015.01.046Shah A.S, Anand A, Strachan F.E, et al. On behalf of the High-STREACS Investigators. High - Sensitivity Troponin in the Evaluation of Patients with Suspected Acute Coronary Syndrome: A Stepped-Wedge, Cluster-Randomised Controlled Trial. Lancet. 2018;Aug 28 (Epub A head of print). doi: 10.1016/S0140-6736(18) 31923-8Melki D, Lugnegard J, Alfredsson J, et al. Implications of Introducing High-Sensitivity Cardiac Troponin T In to Clinical Practice: Data From the SWEDEHEART Registry. J Am Coll Cardiol. 2015;65:1655-64. doi: 10.1016/j.jacc.2015.02.044Mills N. Hot Line Session 5. Presented at: European Society of Cardi ology Congress: Aug 20-29, 2018, Munich. doi:10.1055/a-0744-2163Anand A, Shah A.S.V, Beshiri A, et al. Global Adoption of High-Sen - sitivity Cardiac Troponins and The Universal Definition of Myocardial Infarction. BioRxiv. 2018. doi: 10.1101/371138Thygesen K, Alpert J.S, Allan S.J, et al.: the Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College Cardiology (ACC)/American Heart Association (AHH)/World Heart Federation (WHF) Task Force for The Universal Definition of Myocardial Infarction. Fourth Universal definition of myocardial Infarction (2018). Eur Heart J. 2018;00:1-33. doi: 10.1093/eurheartj/ehy462Sandoval Y, Thygesen K. Myocardial Infarction Type 2 and Myocardial Injury. Clin Chem. 2017;63:101-7. doi: 10.1373/clinchem.2017.255521