生长分化因子-15与稳定性冠心病患者心血管事件相关性的Meta分析

Correlation of Growth Differentiation Factor-15 and Cardiovascular Events in Patients with Stable Coronary Artery Disease:A Meta-Analysis.

目的评价生长分化因子-15(GDF-15)与稳定性冠心病(SCAD)患者心血管事件的相关性。方法检索PubMed、Cochrane图书馆、Embase、Web of Science数据库获取文献。根据纳入、排除标准筛选文献、提取数据。采用Stata 14.0软件进行Meta分析。结果纳入6项研究、共26075例患者。Meta分析结果提示基础GDF-15水平升高,心源性死亡(HR 2.33,95%CI 1.90~2.87,P<0.001)、全因死亡(HR 2.54,95%CI 2.11~3.06,P<0.001)、心肌梗死(HR 1.39,95%CI 1.16~1.66,P<0.001)风险均显著增加,且敏感性分析提示结果稳健;Meta分析结果提示GDF-15水平升高增加心衰风险(HR 2.81,95%CI 1.29~6.14,P=0.009),但行敏感性分析、去除1项研究后结果差异无统计学意义(HR 3.03,95%CI 0.87~10.53);Meta分析结果提示基础GDF-15水平升高,发生缺血性卒中的风险增加(HR 1.81,95%CI 1.19~2.75,P=0.006),但因纳入研究只有2项,未能行敏感性分析评价结果是否稳健。结论在SCAD人群中,基础GDF-15水平升高增加心源性死亡、全因死亡、心肌梗死风险,其与心衰、缺血性卒中风险的关系有待进一步验证。

Objective To evaluate correlation of high-level growth differentiation factor-15(GDF-15)in baseline and cardiovascular events in patients with stable coronary artery disease(SCAD).Methods PubMed,Cochrane Library,EMBASE and Web of Science were searched,and search results were screened and qualified data were extracted according to inclusion and exclusion criteria.Stata 14.0 software was used for meta-analysis.Results Total 6 studies and 26075 participants were included and analyzed.It was showed that cardiac death risk(HR 2.33,95%CI 1.90~2.87,P<0.001),all-cause death(HR 2.54,95%CI 2.11~3.06,P<0.001),and myocardial infarction(HR 1.39,95%CI 1.16~1.66,P<0.001)in SCAD patients with high-level GDF-15 values in baseline was increased significantly,and it was robust demonstrated by sensitivity analyses.Although heart failure risk was increased(HR 2.81,95%CI 1.29~6.14,P=0.009)in patients with high-level GDF-15,there was no statistic difference(HR 3.03,95%CI 0.87~10.53)as a result of sensitivity analyses by omitting one study.Meanwhile,the risk of ischemic stroke was increased(HR 1.81,95%CI 1.19~2.75,P=0.006)in these patients,but it was failed to perform sensitivity analyses because of only two original studies.Conclusion The risk of cardiac death,all-cause death and myocardial infarction was significantly increased in SCAD patients with high-level GDF-15 values in baseline.However,it may need more data to evaluate the correlation of GDF-15 and heart failure and ischemic stroke.