医学
经皮冠状动脉介入治疗
传统PCI
内科学
心脏病学
肌钙蛋白
优势比
肌钙蛋白I
置信区间
前瞻性队列研究
生物标志物
肌钙蛋白T
心肌梗塞
肌酸激酶
生物化学
化学
作者
Yuehua Li,Hanjun Pei,Heerajnarain Bulluck,Chenghui Zhou,Derek J. Hausenloy
出处
期刊:Eurointervention
[Europa Digital and Publishing]
日期:2020-03-01
卷期号:15 (16): 1444-1450
被引量:21
标识
DOI:10.4244/eij-d-19-00737
摘要
The optimal cut-off value of isolated cardiac biomarker elevation for defining prognostically important percutaneous coronary intervention (PCI)-related myocardial injury is not known. We performed a meta-analysis to evaluate the dose-response relationship between isolated cardiac biomarker elevations and the risk of all-cause mortality following elective PCI.Twenty-four prospective studies (44,972 patients) were included. Patients with an isolated elevation of cardiac biomarkers had an increased risk of all-cause mortality when compared to those with no elevations (cardiac troponin I: odds ratio [OR] 1.42, 95% confidence interval [CI]: 1.19-1.69; creatine kinase-MB isoenzyme [CK-MB]: OR 1.43, 95% CI: 1.19-1.70). For the dose-response analysis, elevations of cardiac troponin I >3x or CK-MB >1x the 99th percentile upper reference limit (URL) were associated with increased mortality (cardiac troponin I: OR 1.51, 95% CI: 1.05-2.17; CK-MB: OR 1.25, 95% CI: 1.05-1.48). The pooled OR of mortality for each 3xURL increment of cardiac troponin I or CK-MB was 1.33 (95% CI: 1.15-1.53) and 1.38 (95% CI: 1.30-1.47).We found that a positive dose-response relationship between isolated cardiac troponin I and CK-MB with all-cause mortality and elevated cardiac troponin I >3x or CK-MB >1x the 99th percentile URL was associated with an increased risk of mortality.
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