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Prognostic Role of Admission C-Reactive Protein Level as a Predictor of In-Hospital Mortality in Type-A Acute Aortic Dissection: A Meta-Analysis.
Hsieh, Wan Chin; Henry, Brandon Michael; Hsieh, Chong Chao; Maruna, Pavel; Omara, Mohamed; Lindner, Jaroslav.
Afiliación
  • Hsieh WC; 1 First Faculty of Medicine, Charles University, Prague, Czech Republic.
  • Henry BM; 2 2nd Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
  • Hsieh CC; 3 Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
  • Maruna P; 4 Division of Cardiovascular Surgery, Kaohsiung Medical University School of Medicine, Chung-Ho Memorial Hospital, Kaohsiung.
  • Omara M; 5 Institute of Pathological Physiology and the 3rd Department of Internal Medicine, First Faculty of Medicine, Charles University in Prague, and General University Hospital in Prague, Prague, Czech Republic.
  • Lindner J; 6 Department of Thoracic and Cardiovascular Surgery, Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Vasc Endovascular Surg ; 53(7): 547-557, 2019 Oct.
Article en En | MEDLINE | ID: mdl-31248351
BACKGROUND: Acute aortic dissection (AD) is a lethal vascular disease, accounting for over 90% cases of acute aortic syndrome. Despite advances in understanding associated risk factors, the long-term prognosis for AD patients is still poor. Several prognostic biomarkers have been used for AD as per the IRAD, such as older age (>70 years), onset of chest pain and hypotension, but they are not effective in all patients. Instead, C-reactive protein (CRP) is a consistent inflammatory marker. CRP levels are abnormally increased in AD. However, the prognostic value of serum CRP level in AD remains unclear. OBJECTIVE: To perform a systematic review and meta-analysis (registration no CRD42017056205) to evaluate whether CRP is a biomarker associated with in-hospital mortality in type-A AD. METHODS: PubMed, Web of Science, CNKI, SciELO, and EMBASE were searched for papers published from January 2000 to October 2017 for studies on the prognostic role of CRP at admission in type-A AD patients. Outcome data were extracted and pooled hazard ratios (HRs) were calculated. RESULTS: 18 (N = 2875 patients) studies met the inclusion criteria. Elevated CRP level was associated with a significantly increased risk of in-hospital mortality in patients with type-A AD (HR = 1.15, 95% CI: 1.06-1.25, p = 0.001). The pooled sensitivity of CRP in type-A AD patients was 77% (95% CI 69%-84%, p < 0.001), and the specificity was 72% (95% CI 66%-78%, p < 0.001). CONCLUSION: Elevated CRP level is significantly associated with increased risks of in-hospital mortality in patients with type-A AD. CRP is a convenient prognostic factor in type-A AD patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma de la Aorta / Admisión del Paciente / Proteína C-Reactiva / Mortalidad Hospitalaria / Mediadores de Inflamación / Disección Aórtica Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Vasc Endovascular Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: República Checa Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aneurisma de la Aorta / Admisión del Paciente / Proteína C-Reactiva / Mortalidad Hospitalaria / Mediadores de Inflamación / Disección Aórtica Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Vasc Endovascular Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: República Checa Pais de publicación: Estados Unidos