妊娠相关蛋白A对急性冠脉综合征预后的评价  

Meta-analysis on the prognostic value of pregnancy-associated plasma protein-A in acute coronary syndrome

作　　者：龙曼[1] 陈爱华[1] 邓敏峰[2] 赖文文[1] 梁艺海[1] 

机构地区：[1]南方医科大学附属珠江医院心内科,广州510280 [2]南方医科大学神经外科,广州510280

出　　处：《中华流行病学杂志》2013年第3期279-284,共6页Chinese Journal of Epidemiology

摘　　要：目的定量评价妊娠相关蛋白A对急性冠脉综合征患者未来不良心血管事件发生的预测作用。方法检索PubMed、EMBASE、OVID、WebofKnowledge和CochraneLibrary数据库并手工检索相关参考文献。采用随机效应模型，RR值为效应指标合并妊娠相关蛋白A在急性冠脉综合征预后的相关研究，进行亚组分析识别异质性的来源。结果纳入14篇文献共9413例急性冠脉综合征患者，合并RR值及其95％CI为1．97（1．49～2．60），提示妊娠相关蛋白A可预测急性冠脉综合征患者的预后。研究设计类型、风险效应指标值的选用及随访时间的长短是异质性的主要来源。结论妊娠相关蛋白A是评价急性冠脉综合征患者预后的有效指标，即患者早期血浆妊娠相关蛋白A水平升高预示未来不良心血管事件发生的风险增加。Objective To evaluate the overall prognostic effects of pregnancy-associated plasma protein-A （PAPP-A） in acute coronary syndrome （ACS）through a meta-analysis. Methods Literature was retrieved by formal searching of electronic databases （PubMed, EMBASE, OVID, Web of Knowledge, and the Cochrane Library） and by hand searching of reference lists of related articles. Random effects meta-analysis and relative risk were used to estimate the association between PAPP-A levels and adverse cardiovascular outcomes after ACS as well as preplanned subgroup analyses were conducted to identify the risk-subgroup interactions that could explain the between differences. Results A total of fourteen clinical trials were included in this Meta-analysis which involving 9413 patients. Pooled RR and their 95% confidence intervals （C/s） for all eligible studies was 1.97 （1.49-2.60）, which indicated a prognostic value of PAPP-A in patients with ACS. Differences in study design, measurement of association and duration of follow-up were responsible for the differences in results across the studies. Conclusion Our results suggested that a higher early blood PAPP-A could moderately increase the long-term risk of adverse cardiovascular outcomes and might serve as a valuable prognostic predictor in patients with ACS.

关 键 词：妊娠相关蛋白A 急性冠脉综合征 预后 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]