Systematic review and meta-analysis of postoperative troponin as a predictor of mortality and major adverse cardiac events after vascular surgery

Caruana, Carla Borg; Jackson, Sarah M.; Khuong, Jacqueline Ngyuen; Campbell, Ryan; Liu, Zhengyang; Ramson, Dhruvesh M.; Douglas, Ned; Kok, Juliana; Perry, Luke A; Penny-Dimri, Jahan C.

doi:10.1016/j.jvs.2020.03.039

Cited by 19 publications

(12 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As the ratio of neutrophils to lymphocytes, NLR has also been found to be elevated in atherosclerosis (Balta et al 2016) and cardiovascular disease (Afari & Bhat 2016). More importantly, elevations in NLR have, in recent years, been also found to be of predictive value (both diagnostic and prognostic) in a range of cardiovascular (Kalay et al 2012;Borg Caruana et al 2020;Jackson et al 2020;Liu et al 2020) and ophthalmic conditions such as diabetic retinopathy and age-related macular degeneration (Ulu et al 2013;Ilhan et al 2015). The PLR is a similar emerging inflammatory biomarker that elevates in thrombocytosis and lymphopenia.…”

Section: Discussionmentioning

confidence: 99%

The association of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio with retinal vein occlusion: a systematic review and meta‐analysis

Liu

Perry

Penny-Dimri

et al. 2021

Acta Ophthalmologica

Self Cite

View full text Add to dashboard Cite

The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) are emerging haematological inflammatory biomarkers. However, their significance in retinal vein occlusion (RVO) and its subtypes, branch and central RVO (BRVO and CRVO, respectively), is uncertain. This systematic review and meta‐analysis aimed to clarify the association of NLR and PLR with RVO. We searched MEDLINE (Ovid), EMBASE (Ovid) and the Cochrane Library for studies investigating the association of NLR and PLR with RVO from inception to 2 December 2020. We used random‐effects inverse‐variance modelling to generate pooled effect measures. We used bivariate Bayesian modelling to meta‐analyse the ability of NLR and PLR to differ between individuals with and without RVO and performed meta‐regression and sensitivity analyses to explore inter‐study heterogeneity. Eight studies published encompassing 1059 patients were included for analysis. Both NLR and PLR were significantly elevated in RVO, with pooled mean differences of 0.63 (95% confidence interval (CI) 0.31–0.95) and 21.49 (95% CI 10.03–32.95), respectively. The pooled sensitivity, specificity and area under the Bayesian summary receiver operating characteristic curve were, respectively, 0.629 (95% credible interval (CrI) 0.284–0.872), 0.731 (95% CrI 0.373–0.934) and 0.688 (95% CrI 0.358–0.872) for NLR; and 0.645 (95% CrI 0.456–0.779), 0.616 (95% CrI 0.428–0.761) and 0.621 (95% CrI 0.452–0.741) for PLR. Mean and variability of age and diabetes mellitus prevalence partially explained between‐study heterogeneity. NLR and PLR are significantly elevated in RVO. Future research is needed to investigate the potential prognostic value and independence of these findings.

show abstract

Section: Discussionmentioning

confidence: 99%

The association of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio with retinal vein occlusion: a systematic review and meta‐analysis

Liu

Perry

Penny-Dimri

et al. 2021

Acta Ophthalmologica

Self Cite

View full text Add to dashboard Cite

show abstract

“… 20 Moreover, elevated postoperative troponins were strongly associated with worse survival and greater likelihood of MACE after vascular surgery, regardless of whether symptoms of myocardial ischemia were present. 21 …”

Section: Discussionmentioning

confidence: 99%

“…In a study of patients with Fontaine stage II PAD undergoing treadmill testing, elevated baseline high sensitivity troponin levels were significantly associated with the risk of developing an exercise‐induced myocardial ischemia, that is, significant ST segment depression (≥0.2 mV) 20 . Moreover, elevated postoperative troponins were strongly associated with worse survival and greater likelihood of MACE after vascular surgery, regardless of whether symptoms of myocardial ischemia were present 21 …”

Section: Discussionmentioning

confidence: 99%

Cardiac troponins predict mortality and cardiovascular outcomes in patients with peripheral artery disease: A systematic review and meta‐analysis of adjusted observational studies

Vrsalović

Presečki

Aboyans

2022

Clinical Cardiology

View full text Add to dashboard Cite

Background A significant proportion of patients (pts) with peripheral artery disease (PAD) have concomitant coronary artery disease and polyvascular involvement contributes to increased risk of death and unfavorable cardiovascular events. Hypothesis Cardiac troponins are associated with adverse cardiovascular outcomes in PAD pts. Methods We systematically searched Medline and Scopus to identify all observational cohort studies published before June 2021 (combining terms “troponin,” “peripheral artery disease,” “peripheral arterial disease,” “intermittent claudication,” and “critical limb ischemia”) that evaluated the prognostic impact of troponin rise on admission on all‐cause mortality and/or major cardiovascular events (MACEs; composite of myocardial infarction, stroke, and cardiovascular death) in PAD pts followed up at least 6 months. A meta‐analysis was conducted using the generic inverse variance method. Heterogeneity between studies was investigated using Cochrane's Q test and I2 statistic. Results Eight studies were included in the final analysis (5313 pts) with a median follow‐up of 27 months (interquartile range: 12–59 months). The prevalence of troponin positivity was 5.3% (range: 4.4%–8.7%) in pts with intermittent claudication, and 62.6% (range: 33.6%–85%) in critical limb ischemia. Elevated troponins were significantly associated with an increased risk of all‐cause mortality (hazard ratio [HR]: 2.85, 95% confidence interval [CI]: 2.28–3.57; I2 = 50.97%), and MACE (HR: 2.58, 95% CI: 2.04–3.26; I2 = 4.00%) without publication bias (p = .24 and p = .10, respectively). Conclusion Troponin rise on admission is associated with adverse long‐term cardiovascular outcomes in symptomatic PAD.

show abstract

“…At the time of writing (March 2021), all projects brought to retreat are either published 4 or undergoing peer review 2 in international journals 10–12 . The time to publication of works completed at the retreat ranged from 5 to 18 months.…”

Section: Figmentioning

confidence: 99%

Academic research retreat: a novel approach to maximize the research and publication efforts of medical students and junior doctors

Ramson

Penny-Dimri

Perry

2021

ANZ Journal of Surgery

Self Cite

View full text Add to dashboard Cite

Systematic review and meta-analysis of postoperative troponin as a predictor of mortality and major adverse cardiac events after vascular surgery

Cited by 19 publications

References 53 publications

The association of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio with retinal vein occlusion: a systematic review and meta‐analysis

The association of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio with retinal vein occlusion: a systematic review and meta‐analysis

Cardiac troponins predict mortality and cardiovascular outcomes in patients with peripheral artery disease: A systematic review and meta‐analysis of adjusted observational studies

Academic research retreat: a novel approach to maximize the research and publication efforts of medical students and junior doctors

Contact Info

Product

Resources

About