Zhu Luyu, Liu Ziyan, Zhang Shiqi, Wang Xiaoyan, Fan Yu
Department of Gastroenterology, The Suqian Clinical College of Xuzhou Medical University, Suqian, Jiangsu, China, 223800.
Cancer Institute, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China, 212002.
Heliyon. 2024 Sep 26;10(19):e38565. doi: 10.1016/j.heliyon.2024.e38565. eCollection 2024 Oct 15.
The prognostic implication of phosphorus level in patients with coronary artery disease (CAD) remains controversial. We aimed to conduct a meta-analysis to evaluate the prognostic role of blood phosphorus level in CAD patients.
We searched the PubMed, Web of Science, Scopus, and Embase databases until December 28, 2023, to identify prospective or retrospective longitudinal observational studies that examined the prognostic value of blood phosphorus level in CAD patients. Outcome measures included all-cause or cardiovascular mortality, heart failure, stroke, and major adverse cardiac events (MACEs). The prognostic value of blood phosphorus level was expressed by pooling the fully adjusted hazard ratios (HR) with 95 % confidence intervals (CI) for the hypophosphatemia or hyperphosphatemia compared to the reference normal phosphorus level.
Six studies involving 19,553 CAD patients were included. Meta-analysis showed that the hyperphosphatemia was significantly associated with higher risk of all-cause mortality (HR 1.39; 95 % CI 1.20-1.61), cardiovascular mortality (HR 1.37; 95 % CI 1.22-1.53), heart failure (HR 1.64; 95 % CI 1.44-1.87), and MACEs (HR 1.39; 95 % CI 1.03-1.88) but not stroke (HR 1.23; 95 % CI 0.79-1.92). However, non-significant association was found between hypophosphatemia and all-cause mortality (HR 1.21; 95 % CI 0.98-1.51), cardiovascular mortality (HR 1.07; 95 % CI 0.78-1.45), heart failure (HR 0.87; 95 % CI 0.72-1.05), stroke (HR 1.12; 95 % CI 0.76-1.67), and MACEs (HR 1.16; 95 % CI 0.99-1.36).
Hyperphosphatemia, but not hypophosphatemia independently predicts all-cause mortality, cardiovascular mortality, heart failure, and MACEs in CAD patients.
冠状动脉疾病（CAD）患者中磷水平的预后意义仍存在争议。我们旨在进行一项荟萃分析，以评估血磷水平在CAD患者中的预后作用。
我们检索了PubMed、科学网、Scopus和Embase数据库，直至2023年12月28日，以确定前瞻性或回顾性纵向观察性研究，这些研究探讨了血磷水平在CAD患者中的预后价值。结局指标包括全因或心血管死亡率、心力衰竭、中风和主要不良心脏事件（MACE）。血磷水平的预后价值通过汇总与参考正常磷水平相比的低磷血症或高磷血症的完全调整风险比（HR）及95%置信区间（CI）来表示。
纳入了6项涉及19553例CAD患者的研究。荟萃分析表明，高磷血症与全因死亡率（HR 1.39；95%CI 1.20-1.61）、心血管死亡率（HR 1.37；95%CI 1.22-1.53）、心力衰竭（HR 1.64；95%CI 1.44-1.87）和MACE（HR 1.39；95%CI 1.03-1.88）的较高风险显著相关，但与中风无关（HR 1.23；95%CI 0.79-1.92）。然而，低磷血症与全因死亡率（HR 1.21；95%CI 0.98-1.51）、心血管死亡率（HR 1.07；95%CI 0.78-1.45）、心力衰竭（HR
