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Prognostic effect of cardiac troponin elevation in acute aortic dissection: A meta-analysis
1School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Vascular Medicine, Cardiovascular Center, Sisters of Charity University Hospital Center, Vinogradska cesta 29, 10000 Zagreb, Croatia.
Insights
Cardiac troponin elevation in patients with acute aortic dissection (AAD) is linked to a higher risk of in-hospital death. This finding aids in the prognostic assessment of AAD patients.
Area of Science:
- Cardiology
- Emergency Medicine
- Biomarker Research
Background:
- Acute aortic dissection (AAD) is a life-threatening emergency.
- Current biomarkers lack significant prognostic value in AAD.
- The prognostic role of cardiac troponin in AAD mortality is not well-established.
Purpose of the Study:
- To evaluate the prognostic significance of elevated cardiac troponin in patients diagnosed with AAD.
- To determine if cardiac troponin can predict in-hospital mortality in AAD.
Main Methods:
- Updated systematic review and meta-analysis of relevant studies.
- Included four studies in the final analysis.
- Assessed the association between troponin levels and short-term mortality.
Main Results:
- Elevated cardiac troponin detected in 26.8% of AAD patients (range 23-33%).
- Significantly associated with increased short-term mortality risk (OR 2.57; 95% CI 1.66-3.96).
- Low heterogeneity (I² 34.3%) and no detected publication bias.
Conclusions:
- Cardiac troponin elevation upon admission for AAD indicates a higher risk of in-hospital mortality.
- Cardiac troponin serves as a valuable prognostic marker in AAD management.
Background:
Acute aortic dissection (AAD) is a highly lethal medical emergency that requires immediate assessment and therapy. To date, no one biomarker plays a significant role in risk stratification of patients with AAD and whether cardiac troponin could be a prognostic marker of in-hospital mortality is still unknown.
Methods And Results:
To assess the prognostic role of cardiac troponin elevation during AAD, we performed an updated systematic review and meta-analysis. Four studies were included in the final analysis. Elevated cardiac troponin was present in 26.8% of patients with AAD and ranged between 23% and 33%. We showed that elevated troponin levels were significantly associated with increased risk of short-term mortality (OR 2.57; 95% CI 1.66-3.96). The analysis of pooled studies showed a low heterogeneity (I(2) 34.3%), and no publication bias was detected (Egger bias 3.34, p=0.18).
Conclusions:
Cardiac troponin elevation at the time of admission for AAD is associated with an increased risk of in-hospital mortality.
