Diagnostic and prognostic value of serum C-reactive protein in heart failure with preserved ejection fraction: a systematic review and meta-analysis.
Diagnostic and prognostic value of serum C-reactive protein in heart failure with preserved ejection fraction: a systematic review and meta-analysis.
复制标题
DOI：
10.1007/s10741-020-09927-x
复制
发表时间：
2021-09
影响因子：
4.6
通讯作者：
Li KHC
中科院分区：
文献类型：
--
作者：
Lakhani I;Wong MV;Hung JKF;Gong M;Waleed KB;Xia Y;Lee S;Roever L;Liu T;Tse G;Leung KSK;Li KHC
心力衰竭（HF）是一种主要的流行病，发病率和死亡率不断上升，阻碍了全球医疗保健系统。虽然一些研究已经证明了CRP在预测（i）HFpEF的发展和（ii）HFpEF患者的长期临床结局方面的价值，但其他研究显示没有这种相关性。因此，我们进行了以下系统回顾和荟萃分析，以评估CRP在HFpEF中的诊断和预后作用。使用以下检索词检索PubMed和Embase中评估CRP和HFpEF之间关系的研究：（（（C反应蛋白）和（（保留射血分数）或（舒张性心力衰竭）））。检索期为从数据库开始至2019年8月6日，无语言限制。共从PubMed和Embase分别获得312和233篇研究，其中19篇研究被纳入。我们的荟萃分析表明，高CRP不仅可以预测新发HFpEF的发生，（HR：1.08; 95% CI：1.00-1.16; P = 0.04; I2 = 22%），但作为分类时，心血管死亡风险也增加（HR：2.52; 95% CI：1.61-3.96; P < 0.0001; I2 = 19%）或连续变量（HR：1.24; 95% CI：1.04-1.47; P = 0.01; I2 = 28%），以及用作分类时的全因死亡率（HR：1.78; 95% CI：1.53-2.06; P < 0.00001; I2 = 0%）或连续变量：（HR：1.06; 95% CI：1.02-1.06; P = 0.003; I2 = 61%）。CRP可用作预测HFpEF患者的HFpEF发展和长期临床结局的生物标志物，从而证明其作为一种简单、可访问的参数用于指导该患者人群的临床管理是合理的。然而，仍然需要更多的前瞻性研究，不仅要探讨CRP在HFpEF中的效用和动态性，还要确定纳入CRP的风险分层算法是否真的在改善患者预后方面提供了实质性益处。本文的在线版本（10.1007/s10741-020-09927-x）包含补充材料，可供授权用户使用。
Heart failure (HF) is a major epidemic with rising morbidity and mortality rates that encumber global healthcare systems. While some studies have demonstrated the value of CRP in predicting (i) the development of HFpEF and (ii) long-term clinical outcomes in HFpEF patients, others have shown no such correlation. As a result, we conducted the following systematic review and meta-analysis to assess both the diagnostic and prognostic role of CRP in HFpEF. PubMed and Embase were searched for studies that assess the relationship between CRP and HFpEF using the following search terms: (((C-reactive protein) AND ((preserved ejection fraction) OR (diastolic heart failure))). The search period was from the start of database to August 6, 2019, with no language restrictions. A total of 312 and 233 studies were obtained from PubMed and Embase respectively, from which 19 studies were included. Our meta-analysis demonstrated the value of a high CRP in predicting the development of not only new onset HFpEF (HR: 1.08; 95% CI: 1.00–1.16; P = 0.04; I2 = 22%), but also an increased risk of cardiovascular mortality when used as a categorical (HR: 2.52; 95% CI: 1.61–3.96; P < 0.0001; I2 = 19%) or a continuous variable (HR: 1.24; 95% CI: 1.04–1.47; P = 0.01; I2 = 28%), as well as all-cause mortality when used as a categorical (HR: 1.78; 95% CI: 1.53–2.06; P < 0.00001; I2 = 0%) or a continuous variable: (HR: 1.06; 95% CI: 1.02–1.06; P = 0.003; I2 = 61%) in HFpEF patients. CRP can be used as a biomarker to predict the development of HFpEF and long-term clinical outcomes in HFpEF patients, in turn justifying its use as a simple, accessible parameter to guide clinical management in this patient population. However, more prospective studies are still required to not only explore the utility and dynamicity of CRP in HFpEF but also to determine whether risk stratification algorithms incorporating CRP actually provide a material benefit in improving patient prognosis. The online version of this article (10.1007/s10741-020-09927-x) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
5.4
作者：
Abernethy A;Raza S;Sun JL;Anstrom KJ;Tracy R;Steiner J;VanBuren P;LeWinter MM
通讯作者：
LeWinter MM
影响因子：
3
作者：
Lourenco, Patricia;Pereira, Joana;Bettencourt, Paulo
通讯作者：
Bettencourt, Paulo
影响因子：
5.5
作者：
Chen, Wei-Siang;Chen, Shih-Jen;Wang, Chao-Hung
通讯作者：
Wang, Chao-Hung
影响因子：
24
作者：
Greenland, Philip;Alpert, Joseph S.;Whitman, Gayle R.
通讯作者：
Whitman, Gayle R.
影响因子：
2.5
作者：
Imai, Ryo;Uemura, Yusuke;Murohara, Toyoaki
通讯作者：
Murohara, Toyoaki