生长分化因子-15预测急性冠状动脉综合征患者的预后：一项荟萃分析。
Growth differentiation factor-15 predicts the prognoses of patients with acute coronary syndrome: a meta-analysis.
作者信息
Zhang Shangshi, Dai Dongjun, Wang Xian, Zhu Hongyan, Jin Hongchuan, Zhao Ruochi, Jiang Liting, Lu Qi, Yi Fengying, Wan Xiangxiang, Cui Hanbin
机构信息
Department of Cardiovascular, Ningbo First Hospital, Ningbo, 315010, China.
Department of Cardiovascular, Shangrao People 's Hospital, Shangrao, 334000, China.
出版信息
BMC Cardiovasc Disord. 2016 May 6;16:82. doi: 10.1186/s12872-016-0250-2.
BACKGROUND
Recent studies have shown Growth differentiation factor-15 (GDF-15) that is a member of the transforming growth factor β (TGF-β) superfamily might be a potential predictive cytokine for the prognosis of Acute coronary syndrome (ACS). However, there are discrepancies in these studies.
METHODS
Publication searches of the PubMed/Medline and EMBASE databases were performed without any time or ethnicity restrictions. The inclusion and exclusion criteria, when clear, were addressed. Random effects models were used for all analyses. Publication bias was tested using funnel plots and the Egger test.
RESULTS
We identified eight eligible studies that provided mortality data. Five of these studies provided recurrent myocardial infarction (MI) data. The maximal duration of follow-up ranged from 6 months to 6 years. A significant association was found between the patients with the highest and lowest GDF-15 levels (overall analyses) in terms of mortality (p < 0.00001; RR = 6.08; 95 % CI = 4.79-7.71) and recurrent MI (p < 0.00001; RR = 1.76; 95 % CI = 1.49-2.07). We also found significant associations between the subgroup analyses stratified by ACS types, cutoff points and follow-up durations (p < 0.001). The combined hazard ratio was high for GDF-15 to ACS (HR = 1.656, 95 % CI = 1.467-1.871).
CONCLUSION
High plasma GDF-15 levels are associated with an increased risk of mortality and recurrent MI in patients with ACS.
背景
近期研究表明，生长分化因子-15（GDF-15）作为转化生长因子β（TGF-β）超家族的一员，可能是急性冠状动脉综合征（ACS）预后的潜在预测细胞因子。然而，这些研究存在差异。
方法
对PubMed/Medline和EMBASE数据库进行文献检索，无时间或种族限制。明确纳入和排除标准。所有分析均采用随机效应模型。使用漏斗图和Egger检验检测发表偏倚。
结果
我们确定了八项提供死亡率数据的合格研究。其中五项研究提供了复发性心肌梗死（MI）数据。随访的最长持续时间为6个月至6年。在死亡率（p < 0.00001；RR = 6.08；95%CI = 4.79 - 7.71）和复发性心肌梗死方面（p < 0.00001；RR = 1.76；95%CI = 1.49 - 2.07），GDF-15水平最高和最低的患者之间存在显著关联（总体分析）。我们还发现，按ACS类型、截断点和随访持续时间分层的亚组分析之间存在显著关联（p < 0.001）。GDF-15与ACS的合并风险比很高（HR = 1.656，95%CI = 1.467 - 1.871）。
结论
ACS患者血浆GDF-15水平升高与死亡风险和复发性心肌梗死风险增加相关。
Zotero 插件