Cardiac troponins predict mortality and cardiovascular outcomes in patients with peripheral artery disease: A systematic review and meta‐analysis of adjusted observational studies

Znanstveni rad - Pregledni rad

• Autor: Mislav Vrsalović
• Autor: Ana Vrsalović Presečki
• Autor: Victor Aboyans
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA INTERNU MEDICINU)
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti; Interna medicina

Sažetak (engleski)

Background: A significant proportion of patients (pts) with peripheral artery disease (PAD) have concomitant coronary artery disease and polyvascular involvement contributes to increased risk of death and unfavorable cardiovascular events.
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Hypothesis: Cardiac troponins are associated with adverse cardiovascular outcomes in PAD pts.
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Methods: We systematically searched Medline and Scopus to identify all observational cohort studies published before June 2021 (combining terms "troponin," "peripheral artery disease," "peripheral arterial disease," "intermittent claudication," and "critical limb ischemia") that evaluated the prognostic impact of troponin rise on admission on all-cause mortality and/or major cardiovascular events (MACEs; composite of myocardial infarction, stroke, and cardiovascular death) in PAD pts followed up at least 6 months. A meta-analysis was conducted using the generic inverse variance method. Heterogeneity between studies was investigated using Cochrane's Q test and I2 statistic.
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Results: Eight studies were included in the final analysis (5313 pts) with a median follow-up of 27 months (interquartile range: 12-59 months). The prevalence of troponin positivity was 5.3% (range: 4.4%-8.7%) in pts with intermittent claudication, and 62.6% (range: 33.6%-85%) in critical limb ischemia. Elevated troponins were significantly associated with an increased risk of all-cause mortality (hazard ratio [HR]: 2.85, 95% confidence interval [CI]: 2.28-3.57; I2 = 50.97%), and MACE (HR: 2.58, 95% CI: 2.04-3.26; I2 = 4.00%) without publication bias (p = .24 and p = .10, respectively).
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Conclusion: Troponin rise on admission is associated with adverse long-term cardiovascular outcomes in symptomatic PAD.

• Ključne riječi (engleski): Humans; Intermittent Claudication; Myocardial Infarction; Peripheral Arterial Disease / diagnosis; Peripheral Arterial Disease / epidemiology; Risk Factors; Stroke / epidemiology; Troponin
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Pregledni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: Clinical Cardiology
• Brojčani podaci: vol. 45, br. 2, str. 198-204
• p-ISSN: 0160-9289
• e-ISSN: 1932-8737
• DOI: https://doi.org/10.1002/clc.23776
• URN:NBN: urn:nbn:hr:105:186429
• Datum objave publikacije: 2022-02
• URL dokumenta: https://onlinelibrary.wiley.com/doi/10.1002/clc.23776
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2022-10-26 07:33:10