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

Autori
Vrsalović, Mislav ; Vrsalović Presečki, Ana ; Aboynas, Victor

Izvornik
Clinical cardiology (0160-9289) 45 (2022), 2; 198-204

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
critical limb ischemia ; major cardiovascular events ; meta-analysis ; mortality ; peripheral artery disease ; troponin

Sažetak
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. Hypothesis: Cardiac troponins are associated with adverse cardiovascular outcomes in PAD pts. 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. 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). Conclusion: Troponin rise on admission is associated with adverse long-term cardiovascular outcomes in symptomatic PAD. Keywords: critical limb ischemia ; major cardiovascular events ; meta-analysis ; mortality ; peripheral artery disease ; troponin.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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