Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, China.
Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, China.
Clin Chim Acta. 2018 Feb;477:48-52. doi: 10.1016/j.cca.2017.11.040. Epub 2017 Dec 2.
The prognostic value of cardiac troponin elevation in atrial fibrillation (AF) is unclear.
To investigate the association of cardiac troponin elevation with adverse outcomes in AF by conducting a meta-analysis.
We systematically searched the PubMed and Embase databases until April 2017 for studies assessing the association of cardiac troponin-T (cTnT) or troponin-I (cTnI) elevation with adverse outcomes in AF. The outcome measures were all-cause mortality and major adverse cardiac events (MACEs: death, stroke, myocardial infarction, pulmonary embolism, major bleeding, or revascularization).
Six studies involving 22,697 AF patients were identified. Meta-analysis showed that AF with elevated cardiac troponin was independently associated with increased risk of all-cause mortality (HR 2.04; 95% CI 1.56-2.67) and MACEs (HR 1.93; 95% CI 1.61-2.30). Furthermore, the prognostic value of cardiac troponin elevation was consistently found irrespective of method determination, type of troponin measured, sample size, and study quality subgroup.
AF with cardiac troponin elevation was independently associated with increased risk of all-cause mortality and MACEs. Therefore, determination of troponin should be considered for risk stratification in AF.
心脏肌钙蛋白升高对心房颤动（AF）的预后价值尚不清楚。
通过荟萃分析研究心脏肌钙蛋白升高与 AF 不良结局的关系。
我们系统地检索了 PubMed 和 Embase 数据库，直到 2017 年 4 月，以评估心脏肌钙蛋白 T（cTnT）或肌钙蛋白 I（cTnI）升高与 AF 不良结局之间关系的研究。结局指标为全因死亡率和主要不良心脏事件（MACEs：死亡、中风、心肌梗死、肺栓塞、大出血或血运重建）。
确定了 6 项涉及 22697 例 AF 患者的研究。荟萃分析显示，心脏肌钙蛋白升高的 AF 与全因死亡率（HR 2.04；95%CI 1.56-2.67）和 MACEs（HR 1.93；95%CI 1.61-2.30）的风险增加独立相关。此外，无论测定方法、测量的肌钙蛋白类型、样本量和研究质量亚组如何，心脏肌钙蛋白升高的预后价值都是一致的。
心脏肌钙蛋白升高的 AF 与全因死亡率和 MACEs 的风险增加独立相关。因此，在 AF 中应考虑测定肌钙蛋白进行风险分层。
