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Review
. 2021 Mar;60(1):115-119.
doi: 10.20471/acc.2021.60.01.16.

ADMISSION CARDIAC TROPONINS PREDICT HOSPITAL MORTALITY IN TYPE A ACUTE AORTIC DISSECTION: A META-ANALYSIS OF ADJUSTED RISK ESTIMATES

Mislav Vrsalović  1 , Ana Vrsalović Presečki  1
Affiliations
Review

ADMISSION CARDIAC TROPONINS PREDICT HOSPITAL MORTALITY IN TYPE A ACUTE AORTIC DISSECTION: A META-ANALYSIS OF ADJUSTED RISK ESTIMATES

Mislav Vrsalović et al. Acta Clin Croat. 2021 Mar.

Abstract

Acute aortic dissection (AAD) is a serious medical emergency that requires early diagnosis and rapid treatment. Whether cardiac troponin could be an independent prognostic marker in patients with type A AAD is still unknown. We systematically searched Medline and Scopus to identify all observational cohort studies published before January 2020 that compared outcome (in-hospital mortality) in patients with type A AAD with and without troponin elevation on admission. Four studies with 412 patients were included in final analysis (median age 59 years, 65% of males). A total of 124 (30%) patients died during in-hospital stay, and 73% underwent surgery. Elevated troponins (39.6% of patients) were associated with an increased risk of short-term mortality (adjusted odds ratio 1.26; 95% confidence interval 1.08-1.47), with low heterogeneity among studies (I2 =29.81%). Elevated troponins on admission are independently associated with increased in-hospital mortality in type A AAD.

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

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Figures

Fig. 1
Fig. 1
Study flow diagram for meta-analysis of cardiac troponins and type A acute aortic dissection in-hospital mortality.
Fig. 2
Fig. 2
Meta-analysis of studies testing the association between cardiac troponin elevation on admission and in-hospital mortality in type A AAD (N=412): (A) meta-analysis of studies that reported adjusted ORs (generic inverse variance method, fixed effects model); (B) funnel plot of adjusted ORs of in-hospital mortality. AAD = acute aortic dissection; CI = confidence interval; OR = odds ratio
See this image and copyright information in PMC

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