Prognostic value of cardiac-specific troponins in chronic obstructive pulmonary disease exacerbations: a systematic review.
Prognostic value of cardiac-specific troponins in chronic obstructive pulmonary disease exacerbations: a systematic review.
复制标题
心脏特异性肌钙蛋白在慢性阻塞性肺疾病恶化中的预后价值：系统评价。
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
S. Geraci
中科院分区：
文献类型：
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作者：
N. Chaudary;S. Geraci
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在这一人群中寻找有用的预后信息，并可能确定一组患者，以进行更密集的治疗干预。
背景
心肌肌钙蛋白是诊断和判断心肌梗死预后的敏感而特异的生物标志物。肌钙蛋白升高也可以出现在其他疾病中，并可能有助于预测死亡率。这项系统性综述旨在确定肌钙蛋白升高是否可以预测COPD恶化患者的死亡率(住院期间、短期和长期)。
方法
在PubMed/Medline上搜索相关的英文文章，这些文章测量了因COPD加重而住院的患者的肌钙蛋白T或肌钙蛋白I，并评估了死亡率，无论是否有其他临床结果。只有提供原始数据的重要规模的研究才包括在内。
结果
9份研究报告(4份前瞻性报告，5份回顾报告)符合审查条件。在其中7项研究中，在病情恶化期间肌钙蛋白水平升高的慢性阻塞性肺疾病患者中，死亡率持续上升。一项回顾性研究没有发现对(住院)死亡率的影响，但报告了肌钙蛋白升高的患者的发病率增加(更多的氧气需求和更多的呼吸衰竭)和住院时间增加，而在一项前瞻性研究中，出院的肌钙蛋白T预测住院人数。
结论
这篇综述显示，心肌肌钙蛋白与COPD加重住院患者的死亡率有很强的直接相关性。肌钙蛋白监测可以在这一人群中提供有用的预后信息，并可能确定一组患者以进行更密集的治疗干预。
UNLABELLED
fer useful prognostic information in this population and might identify a group of patients to target for more intensive thera- peutic interventions.
BACKGROUND
Cardiac troponins are specific and sensitive biomarkers used for diagnosis and prognosis in myocardial infarction. Troponin elevations can also occur in other disorders and may be useful to predict mortality. This systematic review is intended to determine whether or not elevated troponins are predictive of mortality (in-hospital, short term, and longer-term) among patients admitted with COPD exacerbation.
METHODS
PubMed/Medline was searched to identify relevant English language articles that measured troponin T or troponin I in patients hospitalized for COPD exacerbation and assessed mortality, with or without other clinical outcomes. Only studies of significant size that presented original data were included.
RESULTS
Nine research reports (4 prospective, 5 retrospective) qualified for review. Mortality was consistently increased in seven of these studies among COPD patients who had elevated troponin levels during an exacerbation. One retrospective study found no effect on (in-hospital) mortality but reported increased morbidity (greater oxygen requirements and more ventilatory failure) and increased length of hospital stay in patients with elevated troponin whereas discharge troponin T in one prospective study predicted hospitalizations.
CONCLUSIONS
The review shows a strong direct association between cardiac troponin and mortality in patients hospitalized for COPD exacerbations. Troponin monitoring could offer useful prognostic information in this population and might identify a group of patients to target for more intensive therapeutics interventions.