| Objective: The relationship between sex,age and acute myocardial infarction(AMI)was analyzed,and to explore the diagnostic significance of different high-sensitivity troponin I(hs-cTnI)cut-off values for AMI,and to provide a reference for early diagnosis of AMI patients.Methods:A total of 236 patients with acute coronary syndrome(ACS)who were admitted to the emergency department of the Second Hospital of Hebei Medical University from February 2019 to December 2019 were selected,and the concentrations of heart injury markers were collected at the time of admission,such ashigh-sensitivity troponin I(hs-cTnI),kinase(CK),creatine kinase isoenzyme-MB mass(CKMB),myoglobin(MYO),classified by sex(male,female),age(low age group,65 years old,high age group s 66 years)and final diagnosis(AMI,Non-AMI),according to the applied subjects working characteristic curve(ROC)and Youdenden index determines the optimal diagnostic demarcation point of hs-cTnI and evaluates the meaning of the cut-off values of different hs-cTnI to the AMI diagnosis.Results: The study included 236 suspected ACS patients,including 130 males and 106 females,males AMI 87,non-AMI43,female AMI48,non-AMI58,and average age of patients(61.95±11.96),of which 155 were in the low age group and 81 in the high age group.The proportion of men with AMI(66.9%)was higher than that of women(45.3%),with the proportion of men in the lower age group having AMI(65.2%)higher than that of women in the lower age group(38.1%),with statistical differences(P<0.05);Differences in cardiomyopathy markers in patients of different genders and ages(P<0.05),male cardiomyopathy markers [hs-cTnI(2.598±3.079),CK(552.207±310.626),CKMB(107.494 ±107.893)]vs.female cardiomyopathy markers [hs-cTnI(1.697±2.002),CK(505.083± 180.153),CKMB(73.792±62.142)];young [hs-cTnI(1.392±1.453)、CK(422.595±202.268)、CKMB(70.083±63.345)]vs.elderly [hs-cTnI(3.736±3.686),CK(627.216±339.663),CKMB(137.392±121.732)].Roc curve shows overall hs-cTnI cut-off value of 0.155ng/ml in AMI patients,0.963(0.930-0.983)for AUC,0.475 ng/ml for male hs-cTnI cut-off under gender definition,0.964 for AUC(0.916-0.989),female hs-cTnI cut-off value 0.13 ng/ml,AUC 0.966(0.911-0.992);age-defined low age group hs-cTnI cut-off value is 0.152ng/ml,AUC is 0.954(0.908-0.981),high age group hs-cTnI cut-off is 0.475 ng/ml,and AUC is 0.993(0.942-1).The sensitivity of AMI diagnosis was 89.83%,89.86% and 96.12% using the general,gender and age hs-cnn I cut-off values,respectively,and the specificity was 96.52%,96.55% and 96.55%,the positive prediction was 96.89%,96.88%,96.88%,and the negative forecast was 88.88%,88.89%,88.89%,and 18.89%,respectively.Conclusions:1.There are gender differences in AMI disease,the proportion of men with AMI is higher than that of women,there is no significant difference between the probability of AMI in low age and high age of the same sex,there is a gender and age difference in the concentration of cardiomyopathy markers in AMI patients,higher than female male,and lower age group patients lower than high age.2.hs-cTnI is a high sensitivity,high specificity index of diagnosis AMI,and different sex,age-defined hs-cTnI cut-off values are different,where male hs-cTnI cut-off value shigher than female,older group patients value higher than low age group.3.Using the cut-off value of hs-cTnI of different populations(gender,age)to increase the specificity and positive prediction value of AMI diagnosis,so as to screen out the AMI high-risk groups more accurately,to avoid misdiagnosis and missed diagnosis. |
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