The Discussion of the Problems of the Use of Markers of Myocardial Necrosis in the Framework of the Russian National Congress of Cardiology (September 20-23, 2016)

Штегман, О. А.; Petrova, M.M.; Марков, В. А.

doi:10.20333/2500136-2017-4-81-85

SMR

2017

DOI: 10.20333/2500136-2017-4-81-85

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The Discussion of the Problems of the Use of Markers of Myocardial Necrosis in the Framework of the Russian National Congress of Cardiology (September 20-23, 2016)

О. А. Штегман¹,

M.M. Petrova²,

В. А. Марков³

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2024

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Cited by 3 publications

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Utility of Point-of-Care Diagnosis of Chronic Heart Failure Using an Express Test for Semi-Quantitative Determination of NT-proBNP Levels

Iosifov,

Shtegman

2024

Kardiologiia

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Aim. To evaluate the accuracy of a rapid test for semi-quantitative determination of NT-proBNP levels in the diagnosis of CHF in comparison with quantitative assessment; to study the strength of the association of the results of this NT-proBNP test with indicators of the CHF severity.Material and methods. The concentration of NT-proBNP was determined in 44 patients at bedside both semi-quantitatively using an express test (BioTest, Novosibirsk) and quantitatively in a laboratory. In 11 patients, the severity of CHF was assessed with the CHF Clinical Status Scale (CSS). Echocardiography was performed in all patients.Results. The sensitivity of the quantitative and semi-quantitative tests coincided and was 95%. The specificity of the quantitative test was 100% in our study, whereas the semi-quantitative test showed a specificity of 92%. The negative predictive value of either test was 96%. The diagnostic accuracy was 98% and 93%, respectively. In patients with significantly high NT-proBNP concentrations, the semi-quantitative test demonstrated a reduced ability to verify values above 1800 pg/ml; in patients with threshold concentrations, the semi-quantitative test showed an increased subthreshold sensitivity. Increases in the NT-proBNP concentration correlated with the severity of CHF according to the stage of the disease.Conclusion. Due to the sufficiently high sensitivity, specificity, ease of use, and speed of obtaining results, the rapid test for semi-quantitative measuring NT-proBNP is promising for outpatient screening bedside diagnosis of CHF and in the emergency room to confirm or exclude CHF. When determining the dynamics of NT-proBNP during the treatment of CHF, the use of the semi-quantitative rapid test with visual assessment of the results may produce an error compared to the quantitative assessment, which will probably not allow tracking the effect of therapy or predicting exacerbation of the disease.

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Utility of Point-of-Care Diagnosis of Chronic Heart Failure Using an Express Test for Semi-Quantitative Determination of NT-proBNP Levels

Iosifov,

Shtegman

2024

Kardiologiia

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The Problems of Interaction Between Pre-Hospital and Hospital Stages With Suspected Acute Coronary Syndrome in Real Life

et al. 2018

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The aim of the study was to study the results of treatment in primary vascular center of patients with suspected acute coronary syndrome (ACS). The study included 543 patients with suspected ACS, delivered by emergency medical service or who applied consistently for 3 months to the primary vascular center and 10 patients with myocardial infarction, hospitalized initially with other diagnoses. The results of electrocardiographic study, studies of markers of myocardial necrosis, coronary angiography, the proportion of hospitalization, 30-day outcomes and cases of repeated inpatient contact were evaluated. Low diagnostic capabilities of the hospital’s receiving department, which does not have an emergency department, in relation to the risk assessment of the patient with chest pain were revealed. Low possibilities of hospitalization of patients with suspected ACS have been established, which leads to delayed hospitalization and mortality of non-hospitalized patients at home. Errors in the diagnosis of myocardial infarction at the prehospital stage lead to diagnostic errors in the hospital. More frequent use of qualitative evaluation of myocardial necrosis markers at the prehospital stage is suggested as ways of solving the problems.

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Early Outcomes in Patients With Suspected Acute Coronary Syndrome Without Persistent St Elevation, Transported to a Vascular Center by Ambulance

Харитонов¹,

Штегман²

2019

Sibirskij medicinskij žurnal

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1 Красноярский государственный медицинский университет имени профессора В. Ф. Войно-Ясенецкого Министерства здравоохранения Российской Федерации, 660022, Российская Федерация, Красноярск, ул. Партизана Железняка, 1 2 Красноярская станция скорой медицинской помощи, 660131, Российская Федерация, Красноярск, пр. Металлургов, 2КЦель: ранние исходы у больных, доставляемых бригадами скорой медицинской помощи в сосудистый центр с подозрением на острый коронарный синдром без подъема ST. Материал и методы. Изучены медицинские документы у 396 пациентов с подозрением на острый коронарный синдром без подъема ST. Проводился телефонный опрос пациентов или их родственников в ближайшие 2 мес. после вызова бригады скорой медицинской помощи. Результаты. Среди пациентов с подозрением на острый коронарный синдром без подъема ST, доставленных в сосудистый центр, только в 30,6% случаев в стационаре подтверждается диагноз. У кардиологов сосудистого центра основой для исключения острого коронарного синдрома без подъема ST является изучение клинических данных и электрокардиограммы. В ближайшие 2 мес. среди пациентов, которым кардиолог сосудистого центра исключил наличие острого коронарного синдрома, 6,4% вызывают скорую медицинскую помощь повторно, 2% госпитализируются в сосудистый центр с острым коронарным синдромом, 2,4% пациентов умирают на дому. Заключение. В реальной клинической практике недостаточно широко используется оценка маркеров некроза при подозрении на острый коронарный синдром без подъема ST. Ключевые слова: острый коронарный синдром, диагностика, исходы, госпитализация, скорая медицинская помощь Конфликт интересов: авторы заявляют об отсутствии конфликта интересов Прозрачность финансовой деятельности: никто из авторов не имеет финансовой заинтересованности в представленных материалах или методах Для цитирования: Харитонов А. А., Штегман О. А. Ближайшие исходы у пациентов, доставленных скорой медицинской помощью в сосудистый центр с подозрением на острый коронарный синдром без стойкого подъема ST. Сибирский медицинский журнал. 2018; 33(4):

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The Discussion of the Problems of the Use of Markers of Myocardial Necrosis in the Framework of the Russian National Congress of Cardiology (September 20-23, 2016)

Cited by 3 publications

References 3 publications

Utility of Point-of-Care Diagnosis of Chronic Heart Failure Using an Express Test for Semi-Quantitative Determination of NT-proBNP Levels

Utility of Point-of-Care Diagnosis of Chronic Heart Failure Using an Express Test for Semi-Quantitative Determination of NT-proBNP Levels

The Problems of Interaction Between Pre-Hospital and Hospital Stages With Suspected Acute Coronary Syndrome in Real Life

Early Outcomes in Patients With Suspected Acute Coronary Syndrome Without Persistent St Elevation, Transported to a Vascular Center by Ambulance

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