我们的研究旨在评估冠状动脉重建手术后急性心肌梗死(AMI)患者血清胱抑素C水平与预后之间的关系。
我们搜索了PubMed,Embase,和Cochrane图书馆至2022年1月21日,无语言限制。结果是主要心血管事件(MACEs)和死亡率。通过随机效应模型合并风险比(RR)和95%置信区间(CI)。
我们在荟萃分析中纳入了8项研究,共7,394名受试者。我们的荟萃分析显示,在冠状动脉血运重建后的AMI患者中,较高的血清胱抑素C水平与较高的MACE风险(RR=2.52,95%CI1.63-3.89,P<0.001)和死亡率(RR=2.64,95%CI1.66-4.19,P<0.001)相关。亚组分析显示,血清胱抑素C水平与AMI患者经皮冠状动脉介入治疗(PCI)后发生MACEs的风险(RR=2.72,95%CI1.32~5.60,P=0.006)和死亡率(RR=2.98,95%CI1.21~7.37,P=0.020)显著相关。然而,在冠状动脉搭桥手术后的AMI患者中,MACEs(RR=2.41,95%CI0.98-5.93,P=0.05)和死亡率(RR=3.15,95%CI0.76-13.03,P=0.10)的风险均无明显升高。进一步的亚组分析显示,MACEs和死亡率的风险显着升高,并没有随着研究样本量的变化而变化。研究人群区域或研究随访时间。
荟萃分析显示,PCI术后AMI患者血清胱抑素C水平升高与MACEs风险和死亡率显著升高相关。它是预测PCI后AMI患者预后的危险分层的生物标志物。
Our study aimed to assess the association between serum cystatin C levels and prognosis in acute myocardial infarction (AMI) patients after coronary reconstructive surgery.
We searched PubMed, Embase, and Cochrane Library up to January 21, 2022 without language restriction. Outcomes were major cardiovascular events (MACEs) and mortality. The risk ratio (RR) and 95% confidence interval (CI) were merged by random-effect models.
We included 8 studies with a total of 7,394 subjects in our meta-analysis. Our meta-analysis showed that higher-level of serum cystatin C levels were associated with higher risk of MACEs (RR = 2.52, 95% CI 1.63-3.89, P < 0.001) and mortality (RR = 2.64, 95% CI 1.66-4.19, P < 0.001) in AMI patients after coronary revascularization. Subgroup analysis showed that the serum cystatin C levels were associated with significantly higher risk of MACEs (RR = 2.72, 95% CI 1.32-5.60, P = 0.006) and mortality (RR = 2.98, 95% CI 1.21-7.37, P = 0.020) in AMI patients after percutaneous coronary intervention (PCI). However, in AMI patients after coronary artery bypass surgery, there were no significantly higher risk of MACEs (RR = 2.41, 95% CI 0.98-5.93, P = 0.05) and mortality (RR = 3.15, 95% CI 0.76-13.03, P = 0.10). Further subgroup analysis showed that this significantly higher risk of MACEs and mortality did not change with the study sample size, study population area or study follow-up time.
The meta-analysis demonstrated that higher serum cystatin C levels were associated with significantly higher risk of MACEs and mortality in AMI patients after PCI. It is a biomarker for risk stratification for predicting the prognosis in AMI patients after PCI.