Relationship of troponin to incident atrial fibrillation occurrence, recurrence after radiofrequency ablation and prognosis: a systematic review, meta-analysis and meta-regression
机构:[a]Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China首都医科大学附属北京同仁医院首都医科大学附属同仁医院[b]Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK[c]Emergency Department of China-Japan Friendship Hospital, Chaoyang District, Beijing, China[d]Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China[e]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China首都医科大学附属安贞医院[f]Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
Objective: To explore the association between the levels of troponin (Tn) and incident atrial fibrillation (AF) occurrence, AF recurrence after radiofrequency ablation (RFA), and the risk trend of AF related prognosis (stroke, major bleeding and mortality). Methods: Twenty-seven studies were included after a systematic search in PubMed from 2005 to 2017, including 13 associated with incident AF occurrence, 8 associated with AF recurrence after RFA and 6 studies evaluating the risk trend of AF-related prognosis with increased Tn levels. Results: Compared with 'no incident AF occurrence' patients, the incident AF occurrence group had similar baseline troponin I (TnI) levels (standardized mean differences [SMD]=0.42, 95% CI: -0.02-0.86, p=0.06; I-2=87.0%, N=6), but higher troponin T (TnT) levels (SMD=3.77, 2.13-5.42, p<0.001; I-2=99.7%, N=8). AF recurrence patients had similar peri-ablation TnI levels, but higher peri-ablation TnT levels compared to the 'no AF recurrence' group with pooled SMD. (TnI: SMD: -0.61, -1.22to 0, p=0.049; I-2=87.1%; TnT: 0.38, 0.14-0.62, p=0.002; I-2=64.7%). On meta-regression, there was an increased risk trend for stroke/systemic embolism (SE) (r(2)=0.93, p=0.04) or major bleeding (r(2)=0.99, p<.0001) with the increasing TnT levels. Mortality was not significantly related to TnI (r(2)=0.09, p=0.25) or TnT (r(2)=0.20, p=0.31), and stroke/SE (r(2)=0.02, p=0.74) or major bleeding (r(2)=0.002, p=0.92) was non-significantly related to increasing TnI levels. Conclusions: In our systematic review, meta-analysis and meta-regression, TnT was associated with both incident AF occurrence and AF recurrence after RFA, as well as stroke/SE and major bleeding. In contrast, TnI was not associated with incident AF occurrence, AF recurrence after RFA or prognosis (stroke/SE, major bleeding).
基金:
This work was supported by grants from the National Science
Foundation of China [81530016], the National Key Research and
Development Program of China [2016YFC0900901] and Beijing Tongren
Hospital, Capital Medical University [2016-YJJ-BJRC-010].
第一作者机构:[a]Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China[b]Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
共同第一作者:
通讯作者:
通讯机构:[a]Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China[b]Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK[e]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China[f]Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark[*1]Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, No. 1, Dong Jiao Min Xiang Street, Dongcheng District, Beijing 100730, China[*2]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, 100029, China[*3]Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, B18 7QH, UK
推荐引用方式(GB/T 7714):
Ying Bai,Shi-Dong Guo,Yue Liu,et al.Relationship of troponin to incident atrial fibrillation occurrence, recurrence after radiofrequency ablation and prognosis: a systematic review, meta-analysis and meta-regression[J].BIOMARKERS.2018,23(6):512-517.doi:10.1080/1354750X.2018.1463562.
APA:
Ying Bai,Shi-Dong Guo,Yue Liu,Chang-Sheng Ma&Gregory Y. H. Lip.(2018).Relationship of troponin to incident atrial fibrillation occurrence, recurrence after radiofrequency ablation and prognosis: a systematic review, meta-analysis and meta-regression.BIOMARKERS,23,(6)
MLA:
Ying Bai,et al."Relationship of troponin to incident atrial fibrillation occurrence, recurrence after radiofrequency ablation and prognosis: a systematic review, meta-analysis and meta-regression".BIOMARKERS 23..6(2018):512-517