白癜风专科的医院 http://www.xftobacco.com/白癜风专科的医院 http://www.xftobacco.com/TODAY今日发布JAHAApr07,:9(7)今日发布03篇（共计32篇）CircCardiovascIntervApr01,:13(4)今日发布01篇（共计02篇）PediatricTransplantationEarlyRecent,Mar25,今日发布02篇Neuromodulation:TechnologyattheNeuralInterfaceEarlyRecent,Mar25,今日发布01篇CATHETERCARDIOINTEEarlyRecent,Mar25,今日发布01篇JAMACardiologyEarlyRecent,Mar25,今日发布09篇ATVBApr01,:40(4)今日发布21篇NEJMMar26,:(13)今日发布23篇ATVBEarlyRecent,Mar26,今日发布07篇StrokeEarlyRecent,Mar26,今日发布07篇CirculationResearchEarlyRecent,Mar26,今日发布01篇RECOMMEND推荐阅读例心房颤动患者肌钙蛋白水平的预后意义（NIHR健康信息学合作研究）JAHAresearch-articleAmitKaura,AhranD.Arnold,etc.2小时前等27用户推荐阅读本文BackgroundPatientspresentingwithatrialfibrillation(AF)oftenundergoabloodtesttomeasuretroponin,butinterpretationoftheresultisimpededbyuncertaintyaboutitsclinicalimportance.Weinvestigatedtherelationshipbetweentroponinlevel,coronaryangiography,andall‐causemortalityinreal‐worldpatientspresentingwithAF.心房颤动（AF）患者经常接受血液检测来测量肌钙蛋白，但对其临床重要性的不确定性阻碍了对结果的解释。我们研究了现实世界中出现房颤患者的肌钙蛋白水平、冠状动脉造影和全因死亡率之间的关系。MethodsandResultsWeusedNationalInstituteofHealthResearchHealthInformaticsCollaborativedatatoidentifypatientsadmittedbetweenandat5tertiarycentersintheUnitedKingdomwithaprimarydiagnosisofAF.Peaktroponinresultswerescaledasmultiplesoftheupperlimitofnormal.Atotalofpatientswereincludedintheanalysis.Overamedianfollow‐upof(interquartilerange,–)days,thereweredeaths(18.8%).Theadjustedhazardratioformortalityassociatedwithapositivetroponin(valueaboveupperlimitofnormal)was1.20(95%CI,1.01–1.43;P0.05).Highertroponinlevelswereassociatedwithhigherriskofmortality,reachingamaximumhazardratioof2.6(95%CI,1.9–3.4)at≈multiplesoftheupperlimitofnormal.Therewasanexponentialrelationshipbetweenhighertroponinlevelsandincreasedoddsofcoronaryangiography.Themortalityriskwas36%lowerinpatientsundergoingcoronaryangiographythaninthosewhodidnot(adjustedhazardratio,0.61;95%CI,0.42–0.89;P=0.01).我们使用英国国家健康研究所健康信息学协作数据，确定年至年在英国5个三级中心住院的初步诊断为房颤的患者。肌钙蛋白峰值结果按正常上限的倍数缩放。共有名患者被纳入分析。在天（四分位数区间，-）的中位随访中，有人死亡（18.8%）。与肌钙蛋白阳性（高于正常值上限）相关的死亡率调整危险比为1.20（95%CI，1.01–1.43；P0.05）。较高的肌钙蛋白水平与较高的死亡率风险相关，在正常上限的倍左右达到2.6（95%CI，1.9-3.4）的最大危险比。较高的肌钙蛋白水平与冠状动脉造影的几率增加呈指数关系。接受冠状动脉造影的患者的死亡率风险比未接受冠状动脉造影的患者低36%（校正危险比，0.61；95%CI，0.42-0.89；P=0.01）。ConclusionsIncreasedtroponinwasassociatedwithincreasedriskofmortalityinpatientspresentingwithAF.ThelowerhazardratioinpatientsundergoinginvasivemanagementraisesthepossibilitythattheclinicalimportanceoftroponinreleaseinAFmaybemediatedbycoronaryarterydisease,whichmayberesponsivetorevascularization.肌钙蛋白升高与房颤患者的死亡率增加相关。接受侵入性治疗的患者的低危险比增加了房颤患者肌钙蛋白释放的临床重要性可能由冠状动脉疾病介导的可能性，冠状动脉疾病可能对血管重建有反应。扫描