1University of Zagreb, School of Medicine, Zagreb, Croatia; 2Department of Cardiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Faculty of Chemical Engineering and Technology, University of Zagreb, Zagreb, Croatia.
Acta Clin Croat. 2021 Mar;60(1):115-119. doi: 10.20471/acc.2021.60.01.16.
Acute aortic dissection (AAD) is a serious medical emergency that requires early diagnosis and rapid treatment. Whether cardiac troponin could be an independent prognostic marker in patients with type A AAD is still unknown. We systematically searched Medline and Scopus to identify all observational cohort studies published before January 2020 that compared outcome (in-hospital mortality) in patients with type A AAD with and without troponin elevation on admission. Four studies with 412 patients were included in final analysis (median age 59 years, 65% of males). A total of 124 (30%) patients died during in-hospital stay, and 73% underwent surgery. Elevated troponins (39.6% of patients) were associated with an increased risk of short-term mortality (adjusted odds ratio 1.26; 95% confidence interval 1.08-1.47), with low heterogeneity among studies ( =29.81%). Elevated troponins on admission are independently associated with increased in-hospital mortality in type A AAD.
急性主动脉夹层（AAD）是一种严重的医疗急症，需要早期诊断和快速治疗。心脏肌钙蛋白是否可以作为 A 型 AAD 患者的独立预后标志物仍不清楚。我们系统地检索了 Medline 和 Scopus，以确定所有在 2020 年 1 月之前发表的比较 A 型 AAD 患者入院时肌钙蛋白升高与不升高的预后（住院死亡率）的观察性队列研究。最终分析纳入了四项共 412 例患者的研究（中位年龄 59 岁，男性占 65%）。共有 124 例（30%）患者在住院期间死亡，73%的患者接受了手术。入院时肌钙蛋白升高（39.6%的患者）与短期死亡率增加相关（校正优势比 1.26；95%置信区间 1.08-1.47），各研究之间的异质性较低（ =29.81%）。入院时肌钙蛋白升高与 A 型 AAD 患者的住院死亡率增加独立相关。
