Prognostic effect of cardiac troponin elevation in acute aortic dissection: A meta-analysis

Abstract

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.

Keywords: Aortic dissection; Meta-analysis; Mortality; Troponin.