Key result
Elevated cardiac troponins on admission are independently associated with an increased risk of in-hospital mortality (adjusted OR 1.26) in patients with type A acute aortic dissection.
Why the study?
Whether cardiac troponin could be an independent prognostic marker in patients with type A acute aortic dissection was unknown.
Does elevated cardiac troponin on admission predict increased in-hospital mortality in patients with type A acute aortic dissection?
Meta-Analysis (n=412)
Does elevated cardiac troponin on admission predict increased in-hospital mortality in patients with type A acute aortic dissection?
Odds Ratio: 1.26 (95% CI 1.08–1.47)
Elevated admission cardiac troponin is an independent prognostic marker associated with increased in-hospital mortality in patients with type A acute aortic dissection.
May aid admission risk stratification in type A aortic dissection; extends observational meta-analysis but leaves practice change open.
Acute aortic dissection (AAD) is a serious medical emergency that requires early diagnosis and rapid treatment. Whether cardiac troponin could be an independent prognostic marker in patients with type A AAD is still unknown. We systematically searched Medline and Scopus to identify all observational cohort studies published before January 2020 that compared outcome (inhospital mortality) in patients with type A AAD with and without troponin elevation on admission. Four studies with 412 patients were included in final analysis (median age 59 years, 65% of males). A total of 124 (30%) patients died during in-hospital stay, and 73% underwent surgery. Elevated troponins (39.6% of patients) were associated with an increased risk of short-term mortality (adjusted odds ratio 1.26; 95% confidence interval 1.08-1.47), with low heterogeneity among studies (I 2 =29.81%). Elevated troponins on admission are independently associated with increased in-hospital mortality in type A AAD.
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Mislav Vrsalović (2021) conducted a meta-analysis in Type A acute aortic dissection (n=412). Elevated cardiac troponins on admission vs. Normal cardiac troponins on admission was evaluated on In-hospital mortality (adjusted OR 1.26, 95% CI 1.08-1.47). Elevated cardiac troponins on admission are independently associated with an increased risk of in-hospital mortality (adjusted OR 1.26) in patients with type A acute aortic dissection.
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