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, 100730, China首都医科大学附属同仁医院[b]University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, United Kingdom[c]Emergency department of China-Japan Friendship Hospital, No. 2 YinghuaDongjie, Hepingli, Chaoyang District,Beijing,100029,China.[d]Department of Cardiology, the First Affiliated Hospital of Harbin Medical University, No.23, YouZheng Street, NanGang District, Harbin 150001, Heilongjiang Province, China.[e]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China临床科室心脏内科中心首都医科大学附属安贞医院[f]Aalborg Thrombosis Research Unit, Department of Clinical Medicine, 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:
National Science Foundation of ChinaNational Natural Science Foundation of China [81530016]; National Key Research and Development Program of China [2016YFC0900901]; 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, 100730, China[b]University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, United Kingdom
共同第一作者:
通讯作者:
通讯机构:[a]Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China[b]University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, United Kingdom[e]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China[f]Aalborg Thrombosis Research Unit, Department of Clinical Medicine, 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]University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, United Kingdom
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