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Master Thesis

Utilisation et interprétation des dosages de troponines cardiaques ultrasensibles dans la vraie vie : ETUDE ACETROPH

Abstract : The blind use of cardiac troponin (cTn) tests leads to difficulties in the clinical interpretation and management of the patient in the face of high results. Objective: to describe and analyze cTn dosing conditions and patterns in a hospital's daily practice, the results, their diagnostic value, and the impact they have had on the management of the patient, especially those without no IDM. Methods: observational cohort study, retrospective, on 508 patients who received at least one dose of CHGM cTnI HS, regardless of motive, value or service, for 30 days. We studied the results of assays, dosing and patient characteristics, prevalence and factors associated with elevation of cTn, dosing patterns, associated end diagnoses, and patient management following cTn assay. Patients were categorized by elevations of cTn or by etiology (type 1, 2, myocardial damage). Results: 22.4% of dosages are high, the majority with a low value (62.3%). A high cTn corresponds to non-cardiovascular diagnosis in 61% of cases, 73.7% of high cTn do not correspond to myocardial ischemia, especially for low values. A quarter of the high cTn is assayed under low SCA pre-test conditions, which never corresponds to an SCA diagnosis in fine. Excluding very high values and diagnosis of type 1 IDM, the elevation of cTn is little associated with specific cardiological management (treatment, coronary angiography, cardio monitoring), or none at all for 20% of the myocardial damage and MDI groups. type 2. But the use of imaging (ETT), the specialist CHGM or hospitalization CHGM are more important. Conclusion: most elevations of cTn are low and correspond to myocardial damage and therefore to a "false positive" in the diagnosis of IDM and do not lead to specific cardiological management.
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Master Thesis
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Marie Feugas. Utilisation et interprétation des dosages de troponines cardiaques ultrasensibles dans la vraie vie : ETUDE ACETROPH. Médecine humaine et pathologie. 2019. ⟨dumas-02519299⟩



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