第三版心肌梗死定义英文版

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1、文档ClinicalBiochemistryVolume46,Issues1–2,January2013,Pages1–4ThirdUniversalDefinitionofMyocardialInfarction·AllanS.Jaffe,IntroductionTheThirdUniversalDefinitionofMyocardialInfarction(MI)wasrecentlypublishedconjointlybythemajorcardiologyorganizationst

2、hroughouttheworldandinthejournalsoftheWorldHealthOrganization(WHO).Thisdefinitionbuildsontwoprevioustwoiterationswhichweredevelopedtomakethediagnosisofmyocardialinfarction(MI)moreconsistent.Theeffortsstartedoriginallyin1999intheconferenceinNicestimul

3、atedbytheinnovationofDr.KristianThygesenandDr.JosephAlbertwhohadrecognizedthisproblemandwhodevelopedataskforcejointlysponsoredbytheACC(AmericanCollegeofCardiology)andtheESC(EuropeanSocietyofCardiology)toattempttostandardizethedefinitionofMI[1].Thisma

4、jorstepledtothefirstdocumentwhichmovedthefieldfromtheepidemiologicallyorienteddefinitionofMIwhichhadbeendevelopedbytheWHOtotracktheincidenceofcoronarydiseaseandthereforewasorientedtowardsspecificitytoamoreclinicallyorienteddefinitionwhichreliedonbiom

5、arkersasakeyfeatureofthediagnosis.Thisresultedinaparadigmshiftwherethediagnosisrequireddocumentationofmyocardialnecrosiswithbiomarkersandespeciallycardiactroponin(cTn)whichwasemergingatthetimeintheproperclinicalsituation.Aseconditerationin2007[2]upda

6、tedtheguidelinesandthe2012definitionrefinesthedefinitionstillfurtherparticularlyasitrelatestobiomarkers[3]whichhaveinthepastdecadebecomeprogressivelymoreandmoresensitive.Intrinsically,increasesinsensitivityofthissorttendtoresultinadiminutionofspecifi

7、citysinceincreasinglysensitivemeasurementsoftenunmasknewetiologiesforinthisinstance,elevationsofthesesensitivecTnbiomarkers.Areasofthe2012definitionthatremainsimportantbutunchanged文档ThedefinitionofMIfromthepathologiccircumstanceobviouslyisnotgoingtoc

8、hange.Thedefinitionmandatesthefindingofcardiomyocytenecrosisdefinedpathologicallyduetomyocardialischemia.However,theclinicaldefinitionsincepathologyisnotreadilyavailabletoguideclinicalcarereliesonasurrogatemarkerforcardiacinjury;i.e.,cardiacbiomarker