Ghalenoo Sara Rashki, Mahmoodi Zohreh
Department of Cardiology, Zabol University of Medical Sciences, Zabol, Iran.
Int J Vasc Med. 2025 Jul 3;2025:1210312. doi: 10.1155/ijvm/1210312. eCollection 2025.
This study is aimed at evaluating the predictive value of high-sensitive cardiac troponin T (hs-TnT), and N-terminal probrain natriuretic peptide (NT-proBNP), for cardiovascular events and/or survival in stable adult congenital heart disease (ACHD) patients. A systematic review along with a meta-analysis was done on studies from 2014 to 2024 that examined hs-TnT, NT-proBNP, and their association with cardiac events and/or mortality in adult patients with congenital heart disease. A comprehensive search was conducted across major databases, and studies reporting biomarker levels and relevant outcomes were included. Data on study characteristics and hazard ratios (HRs) were extracted, and pooled estimates were calculated using random-effects meta-analysis, with heterogeneity assessed through the statistic. STATA software was used for data analysis. A total of five studies, consisting of 1294 adult congenital heart disease (ACHD) patients, were included in this meta-analysis. Elevated NT-proBNP levels were significantly associated with an increased risk of mortality or cardiac events (HR: 2.13; 95% CI: 1.84-2.42), which remained significant after adjustment for confounding factors (adjusted HR: 2.34; 95% CI: 1.55-3.13). Elevated hs-TnT levels were also associated with a higher risk of adverse outcomes (HR: 1.57; 95% CI: 1.36-1.78), with the association remaining significant after adjustment (adjusted HR: 2.65; 95% CI: 1.22-5.76). Sensitivity analysis excluding a study with a lower hs-TnT cut-off further strengthened the association (adjusted HR: 3.03; 95% CI: 0.86-5.21) and reduced heterogeneity. In conclusion, this meta-analysis shows the prognostic value of both NT-proBNP and hs-TnT in adults with congenital heart disease. Each of these markers offered a distinct but complementary clinical insight. Although methodological differences of the included studies limit direct comparison, our systematic review supports the potential value of incorporating both biomarkers into routine risk assessment.
本研究旨在评估高敏心肌肌钙蛋白T（hs-TnT）和N末端脑钠肽前体（NT-proBNP）对稳定型成人先天性心脏病（ACHD）患者心血管事件和/或生存的预测价值。对2014年至2024年期间研究hs-TnT、NT-proBNP及其与先天性心脏病成年患者心脏事件和/或死亡率关联的研究进行了系统综述和荟萃分析。在各大数据库中进行了全面检索，纳入了报告生物标志物水平和相关结局的研究。提取了研究特征和风险比（HRs）数据，并使用随机效应荟萃分析计算合并估计值，通过 统计量评估异质性。使用STATA软件进行数据分析。本荟萃分析共纳入五项研究，包括1294例成人先天性心脏病（ACHD）患者。NT-proBNP水平升高与死亡或心脏事件风险增加显著相关（HR：2.13；95%CI：1.84 - 2.42），在调整混杂因素后仍具有显著性（调整后HR：2.34；95%CI：1.55 - 3.13）。hs-TnT水平升高也与不良结局风险较高相关（HR：1.57；95%CI：1.36 - 1.78），调整后该关联仍具有显著性（调整后HR：2.65；95%CI：1.22 - 5.76）。排除一项hs-TnT临界值较低的研究后的敏感性分析进一步强化了该关联（调整后HR：3.03；95%CI：0.86 - 5.21）并降低了异质性。总之，本荟萃分析显示了NT-proBNP和hs-TnT在先天性心脏病成人患者中的预后价值。这些标志物各自提供了独特但互补的临床见解。尽管纳入研究的方法学差异限制了直接比较，但我们的系统综述支持将这两种生物标志物纳入常规风险评估的潜在价值。
