The predictive value of myocardial markers in the risk assessment of patients with asymptomatic heart disease
心肌标志物在无症状心脏病患者风险评估中的预测价值

摘要

目的 本研究旨在探讨心肌标志物在无症状心脏病患者中预测心脏事件风险的价值。方法 采用前瞻性队列研究设计，纳入2021年9月至2023年3月期间在本院被诊断为无症状心脏病的500名患者，根据心肌标志物水平分为高水平组和低水平组，进行为期24个月的随访，观察心肌标志物水平与心脏事件（如心肌梗死、心力衰竭等）发生的关系。结果 心肌特异性标志物在高浓度组体内的平均含量显著超过了低浓度组，同时高浓度组心脏病发作的比率也远超低浓度组（34%相较于18%）。经过多元Cox回归的分析结果表明，心肌肌钙蛋白T、心脏肌钙蛋白I以及脑钠肽的数值能够独立预测心脏事件的出现。结论 心脏功能指标，尤其是肌钙蛋白T、肌钙蛋白I和脑钠肽，对那些表面未显露症状的心病患者而言，在预判心脏问题发生的危险性方面具备重要的指示作用。这些研究成果突显了针对此类患者群体进行心肌功能指标测评在医疗实践中的必要性，这不但有助于提前对风险进行评估与应对，同时还有利于减少患者整体的心脏健康负担。

Abstract

Objective This study aims to explore the value of myocardial markers in predicting the risk of cardiac events in patients with asymptomatic heart disease.
Methods A prospective cohort study design was adopted. A total of 500 patients diagnosed with asymptomatic heart disease in our hospital from September 2021 to March 2023 were included. They were divided into a high-level group and a low-level group according to the levels of myocardial markers and were followed up for 24 months to observe the relationship between the levels of myocardial markers and the occurrence of cardiac events (such as myocardial infarction, heart failure, etc.).
Results The average content of myocardial specific markers in the high-concentration group was significantly higher than that in the low-concentration group. Meanwhile, the rate of heart attacks in the high-concentration group was also much higher than that in the ultra-low concentration group (34% compared with 18%). The analysis results of multivariate Cox regression indicated that the values of cardiac troponin T, cardiac troponin I and brain natriuretic peptide could independently predict the occurrence of cardiac events.
Conclusion   Cardiac function indicators, especially troponin T, troponin I and brain natriuretic peptide, play an important indicative role in predicting the risk of cardiac problems for those patients with heart disease who do not show obvious symptoms on the surface. These research results highlight the necessity of evaluating myocardial function indicators for such patient groups in medical practice. This not only helps to assess and respond to risks in advance, but also benefits in reducing the overall burden of cardiac health for patients.