Ding Kejun, Shi Zhewei, Qian Caizhen, Yang Xuan
Department of Cardiology, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, China.
Departments of Cardiology, Qingdao Municipal Hospital, Qingdao, China.
Front Cardiovasc Med. 2022 Jan 10;8:726289. doi: 10.3389/fcvm.2021.726289. eCollection 2021.
Association between plasma pentraxin-3 (PTX-3) and clinical outcomes in patients with coronary artery disease (CAD) remains not fully determined. An updated meta-analysis of cohort studies was performed to systematically evaluate the association. Cohort studies evaluating the association between plasma PTX-3 and adverse outcomes [mortality and major adverse cardiovascular events (MACEs)] in adults with CAD were identified by systematic search of PubMed, Embase, and Web of Science databases. Only studies with multivariate analysis were included. A random-effects model incorporating the potential intrastudy heterogeneity was used for the meta-analysis. A total of 16 studies including 11,007 patients were included. Pooled results showed that patients with highest level of PTX-3 were independently associated with higher risk of mortality [adjusted risk ratio (RR): 2.09, 95% CI: 1.60 to 2.74, < 0.001; = 50%] and MACEs (adjusted RR: 1.80, 95% CI: 1.43 to 2.28, < 0.001; = 49%). Subgroup analyses showed that the associations between PTX-3 and poor prognosis in CAD were consistent in patients with ST-segment elevation myocardial infraction, non-ST-segment elevation acute coronary syndrome, and stable CAD ( < 0.05 for each subgroup). Besides, the association between PTX-3 and increased incidence of mortality and MACEs were consistent in short-term (within 1 year) and long-term (over 1 year) studies and in studies with or without adjustment of C-reactive protein (CRP) ( < 0.05 for each subgroup). Higher plasma PTX-3 is associated with poor prognosis in patients with CAD, which may be independent of the CAD subtype, follow-up durations, and adjustment of CRP.
血浆五聚素3（PTX-3）与冠状动脉疾病（CAD）患者临床结局之间的关联尚未完全明确。我们进行了一项队列研究的更新荟萃分析，以系统评估这种关联。通过系统检索PubMed、Embase和Web of Science数据库，确定了评估血浆PTX-3与CAD成年患者不良结局[死亡率和主要不良心血管事件（MACE）]之间关联的队列研究。仅纳入进行了多变量分析的研究。采用纳入潜在研究内异质性的随机效应模型进行荟萃分析。共纳入16项研究，涉及11,007例患者。汇总结果显示，PTX-3水平最高的患者与更高的死亡风险[调整风险比（RR）：2.09，95%置信区间（CI）：1.60至2.74，P<0.001；I² = 50%]和MACE风险（调整RR：1.80，95%CI：1.43至2.28，P<0.001；I² = 49%）独立相关。亚组分析显示，在ST段抬高型心肌梗死、非ST段抬高型急性冠状动脉综合征和稳定型CAD患者中，PTX-3与CAD预后不良之间的关联是一致的（每个亚组P<0.05）。此外，在短期（1年内）和长期（1年以上）研究以及调整或未调整C反应蛋白（CRP）的研究中，PTX-3与死亡率和MACE发生率增加之间的关联是一致的（每个亚组P<0.05）。血浆PTX-3水平较高与CAD患者预后不良相关，这可能与CAD亚型、随访时间和CRP调整无关。
