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Troponinerhöhung – benötigt jeder Patient eine Koronarangiographie?

Troponin elevation—does every patient require coronary angiography?

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The Original Article was published on 11 January 2021

Zusammenfassung

Die Bestimmung des hochsensitiven Troponins ist der Goldstandard bei Patienten mit akutem Thoraxschmerz und erlaubt die zeitnahe Diagnosestellung und Therapieeinleitung bei Patienten mit akutem Myokardinfarkt (AMI). Erhöhte kardiale Troponinspiegel sind hochspezifisch für das Vorliegen einer akuten myokardialen Schädigung. Hingegen beruht nicht jede myokardiale Schädigung auf einem AMI, sodass bei der Interpretation erhöhter Troponinspiegel immer die Klinik und das 12-Kanal-Elektrokardiogramm mitberücksichtigt werden müssen. Neben dem AMI finden sich bei zahlreichen Erkrankungen erhöhte Troponinspiegel, sodass nicht jeder Patient zwangsläufig einer invasiven Koronardiagnostik unterzogen werden muss.

Abstract

The determination of high-sensitivity troponin remains the gold standard in patients with acute chest pain and allows the early diagnosis and therapy of patients with acute myocardial infarction (AMI). Increased cardiac troponin levels are highly specific for myocardial damage. However, elevated troponin levels are not equivalent to AMI and therefore the clinical presentation and the electrocardiogram of each patient must be taken into account. Elevated troponin levels are found in numerous diseases but not every patient needs invasive coronary angiography.

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  1. Klinik für Kardiologie, Angiologie, Pneumologie und internistische Intensivmedizin, Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland

    Christoph Adler & Stephan Baldus

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Correspondence to Christoph Adler.

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Interessenkonflikt

S. Baldus erhielt Vortragshonorare von Edwards Lifesciences, Bayer Vital, CVRx, MSD SHARP & DOHME GmbH, JenaValve Technology und Abbott sowie Fördermittel von IcoVifor, Symetis SA, Pfizer, JenaValve Technology, Valtech, OptumInsight, Biotronik und Abbott außerhalb der vorliegenden Arbeit. C. Adler gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Adler, C., Baldus, S. Troponinerhöhung – benötigt jeder Patient eine Koronarangiographie?. Med Klin Intensivmed Notfmed 115, 690–698 (2020). https://doi.org/10.1007/s00063-019-0593-4

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