High-sensitivity Troponin (hs-Tn) for Cardiovascular Risk Prognostication: A Systematic Review and Meta-analysis
- Authors: Sagris M.1, Antonopoulos A.2, Angelopoulos A.3, Papanikolaou P.4, Simantiris S.1, Vamvakaris C.4, Koumpoura A.1, Farmaki M.1, Antoniades C.5, Tsioufis C.6, Tousoulis D.2
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Affiliations:
- 1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens
- 1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens,
- 1st Cardiology Clinic, Hippokration General Hospita, National and Kapodistrian University of Athens,
- 1st Cardiology Clinic, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens
- RDM Division of Cardiovascular Medicine, University of Oxford
- 1st Cardiology Clinic, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens,
- Issue: Vol 31, No 14 (2024)
- Pages: 1941-1953
- Section: Anti-Infectives and Infectious Diseases
- URL: https://hum-ecol.ru/0929-8673/article/view/644376
- DOI: https://doi.org/10.2174/0929867330666230315152045
- ID: 644376
Cite item
Full Text
Abstract
Background:Chronic low-grade inflammation is involved in coronary atherosclerosis progression whereas recent research efforts suggest that preventative methods should be tailored to the "residual inflammatory risk". As such, modalities for the early identification of the risk have to be investigated.
Methods:We performed a systematic review and meta-analysis according to the PRISMA guidelines. Any study that presented the prognostic value of high sensitivity troponin (hs-cTn) of vascular inflammation in stable patients without known cardiac heart disease was considered to be potentially eligible. The Medline (PubMed) database was searched up to April 22, 2021. The main endpoint was the difference in c-index (Δ[c-index]) with the use of hs-cTn for major adverse cardiovascular events (MACEs), cardiovascular and all-cause mortality. We calculated I2 to test heterogeneity.
Results:In total, 44 studies and 112,288 stable patients without known coronary heart disease were included in this meta-analysis. The mean follow-up duration of the whole cohort was 6.8 ± 1.1 years. 77,004 (68.5%) of the patients presented at low cardiovascular risk while 35,284 (31.5%) in high. The overall pooled estimate of Δ[c-index] for MACE was 1.4% (95%CI: 0.7-2.1, I2=0%) and for cardiovascular death 1.3% (95%CI: 0.3-2.3, I2=0%). Finally, the overall pooled estimate of Δ[c-index] for all-cause mortality was 3% (95%CI: 1.9-3.9, I2=86%), while high heterogeneity was observed between the studies.
Conclusion:The predictive usefulness of changes in hs-cTn measures in stable individuals with either high or low cardiovascular risk, demonstrates that assessing vascular inflammation in addition to clinical risk factors enhances risk prediction for cardiovascular events and allcause mortality. Further prospective studies are necessary to confirm these findings and assist clinical decision-making regarding the most optimal prevention strategy.
About the authors
Marios Sagris
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens
Author for correspondence.
Email: info@benthamscience.net
Alexios Antonopoulos
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens,
Email: info@benthamscience.net
Andreas Angelopoulos
1st Cardiology Clinic, Hippokration General Hospita, National and Kapodistrian University of Athens,
Email: info@benthamscience.net
Paraskevi Papanikolaou
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens
Email: info@benthamscience.net
Spyridon Simantiris
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens
Email: info@benthamscience.net
Constantinos Vamvakaris
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens
Email: info@benthamscience.net
Alkmini Koumpoura
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens
Email: info@benthamscience.net
Maria Farmaki
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens
Email: info@benthamscience.net
Charalambos Antoniades
RDM Division of Cardiovascular Medicine, University of Oxford
Email: info@benthamscience.net
Constantinos Tsioufis
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens,
Email: info@benthamscience.net
Dimitris Tousoulis
1st Cardiology Clinic, Hippokration General Hospital, School of Medicine,, National and Kapodistrian University of Athens,
Email: info@benthamscience.net
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