a Department of Cardiology State Key Laboratory of Cardiovascular Disease, Fuwai Hospital National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China.
b Department of Cardiology, The First Affiliated Hospital of Baotou Medical College , Baotou , China.
Biomarkers. 2019 Sep;24(6):556-565. doi: 10.1080/1354750X.2019.1606277. Epub 2019 May 31.
Predictive value of cardiac tropnins (cTns) in stable coronary artery disease (SCAD) has not been fully investigated. We performed a meta-analysis to evaluate the dose-response relationship between serum detectable/rising cTns and adverse clinical outcomes, including all-cause mortality, cardiovascular (CV) mortality, myocardial infarction (MI), heart failure (HF) or major adverse cardiovascular events (MACEs) in SCAD. Sixteen studies involved 34,854 subjects were included. Compared with patients with negative/undetectable cTns, those with rising/detectable cTns were associated with increased risk of all-cause mortality, CV mortality, MI, HF and MACEs [the hazard ratio (HR) was 1.83 (95% confidence interval (CI) 1.61-2.08), 2.11 (1.80-2.48), 1.43 (1.26-1.62), 2.36 (1.97-2.83) and 1.99 (1.57-2.53), respectively]. Dose-response analysis have revealed that per 1-SD increment of cTnT was associated with increased risk of all-cause mortality, CV mortality, MI, HF and MACEs [the HR was 1.78 (1.20-2.63), 1.62 (1.41-1.85), 1.26 (1.12-1.42), 1.78 (1.17-2.69) and 1.26 (1.00-1.59), respectively]. Rising/detectable cTns was associated with increased risk of all-cause mortality, CV mortality, MI, HF and MACEs in SCAD in a dose-response manner.
在稳定性冠状动脉疾病（SCAD）中，心脏肌钙蛋白（cTn）的预测价值尚未得到充分研究。我们进行了一项荟萃分析，以评估血清可检测/升高的 cTn 与不良临床结局（包括全因死亡率、心血管（CV）死亡率、心肌梗死（MI）、心力衰竭（HF）或主要不良心血管事件（MACE））之间的剂量-反应关系在 SCAD 中。共有 16 项研究纳入了 34854 例患者。与 cTn 阴性/不可检测的患者相比，cTn 升高/可检测的患者发生全因死亡率、CV 死亡率、MI、HF 和 MACE 的风险增加[风险比（HR）分别为 1.83（95%置信区间（CI）1.61-2.08）、2.11（1.80-2.48）、1.43（1.26-1.62）、2.36（1.97-2.83）和 1.99（1.57-2.53）]。剂量-反应分析表明，cTnT 每增加 1-SD，全因死亡率、CV 死亡率、MI、HF 和 MACE 的风险增加[HR 分别为 1.78（1.20-2.63）、1.62（1.41-1.85）、1.26（1.12-1.42）、1.78（1.17-2.69）和 1.26（1.00-1.59）]。升高/可检测的 cTn 与 SCAD 中全因死亡率、CV 死亡率、MI、HF 和 MACE 的风险增加呈剂量反应关系。
