冠心病患者平均血小板体积的预后价值:最新系统综述与荟萃分析。

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL European Journal of Clinical Investigation Pub Date : 2024-07-31 DOI:10.1111/eci.14295
Akhmetzhan Galimzhanov, Han Naung Tun, Yersyn Sabitov, Francesco Perone, Tigen Mustafa Kursat, Erhan Tenekecioglu, Mamas A Mamas
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引用次数: 0

摘要

背景:平均血小板体积(MPV)是一种广泛使用的实验室指标,但其在冠状动脉疾病(CAD)患者中的预后意义仍不明确。我们打算调查并汇集有关入院时平均血小板容积在预测冠状动脉疾病患者临床结局方面的预后作用的证据:方法:PubMed、Web of Science 和 Scopus 是用于文献检索的主要数据库。采用预后因素研究质量评估偏倚风险。我们使用 Knapp 和 Hartung 方法进行随机效应配对分析,并辅以置换检验和预测区间(PIs):我们确定了 52 项研究,涉及 47066 名患者。对9项研究、14,864名患者进行的荟萃分析表明,MPV值每增加1毫升,整个CAD患者的长期死亡风险就会增加29%(危险比[HR]1.29,95%置信区间[CI]1.22-1.37)。PI、置换检验和撇除敏感性分析进一步证实了这一结果。对于接受经皮冠状动脉介入治疗(PCI)和急性冠状动脉综合征(ACS)的患者,MPV 作为线性变量在预测长期死亡率方面也显示出稳定而显著的预后作用(HR 分别为 1.29,95% CI 1.20-1.39 和 1.29,95% CI 1.19-1.39):该荟萃分析发现了强有力的证据,证明入院时的 MPV 与 CAD 患者、接受 PCI 的患者和出现 ACS 的患者长期死亡风险增加之间存在联系。
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The prognostic value of mean platelet volume in patients with coronary artery disease: An updated systematic review with meta-analyses.

Background: Mean platelet volume (MPV) is a widely available laboratory index, however its prognostic significance in patients with coronary artery disease (CAD) is still unclear. We intended to investigate and pool the evidence on the prognostic utility of admission MPV in predicting clinical outcomes in patients with CAD.

Methods: PubMed, Web of Science, and Scopus were the major databases used for literature search. The risk of bias was assessed using the quality in prognostic factor studies. We used random-effects pairwise analysis with the Knapp and Hartung approach supported further with permutation tests and prediction intervals (PIs).

Results: We identified 52 studies with 47,066 patients. A meta-analysis of nine studies with 14,864 patients demonstrated that one femtoliter increase in MPV values was associated with a rise of 29% in the risk of long-term mortality (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.22-1.37) in CAD as a whole. The results were further supported with PIs, permutation tests and leave-one-out sensitivity analyses. MPV also demonstrated its stable and significant prognostic utility in predicting long-term mortality as a linear variable in patients treated with percutaneous coronary intervention (PCI) and presented with acute coronary syndrome (ACS) (HR 1.29, 95% CI 1.20-1.39, and 1.29, 95% CI 1.19-1.39, respectively).

Conclusion: The meta-analysis found robust evidence on the link between admission MPV and the increased risk of long-term mortality in patients with CAD patients, as well as in patients who underwent PCI and patients presented with ACS.

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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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