The predictive value of microRNAs for adverse prognosis in patients with ST-segment elevation myocardial infarction:a Meta-analysis
刘金良 1魏艳伟 1刘屹 2夏梅华1
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作者信息
1. 053000 衡水市中医医院心血管病科
2. 053000 衡水市中医医院药剂科
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摘要
目的:利用Meta分析的方法系统评价血清microRNAs对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者不良预后的预测价值.方法:计算机检索PubMed、Web of Science、EMbase、the Cochrane Library、中国知网、万方数据、维普数据库和中国生物医学文献数据库,纳入microRNAs预测STEMI预后情况的相关研究,检索时限设定为建库至2023年10月31日.根据诊断性试验研究质量评估量表(quality assessment of diagnostic accuracy studies-2,QUADAS-2)评价文献质量,采用 Stata 17.0、RevMan 5.4 和 Meta-Disc 1.4 软件进行 Meta分析.结果:本研究共纳入14篇国内外研究,涉及STEMI患者1816例,包括预后不良患者593例.随机效应模型合并结果显示,血清microRNAs预测STEMI患者不良预后的合并敏感度为0.78(95％CI:0.75～0.82),合并特异度为0.77(95％CI:0.75～0.79),综合受试者工作特征曲线下面积为0.85(95％CI:0.83～0.88).亚组分析表明不同预后事件、患者是否为急性STEMI、不同样本量可能是造成异质性的原因.Deek's对称性检验表明不存在潜在的发表偏倚(t=1.10,P=0.29).Fagan's列线图显示,应用血清microRNAs后,STEMI患者不良预后事件被正确预测的概率由50％上升至78％,预后良好患者被误判的概率由50％下降至21％.结论:本研究通过Meta分析的方法,共纳入14篇文献,发现血清microRNAs对STEMI患者不良预后具有一定预测价值,在STEMI患者预后管理中具有较好的应用前景.
Abstract
Objective:To systematically evaluate the predictive value of microRNAs for adverse prognosis in patients with ST-segment elevation myocardial infarction(STEMI).Methods:Systematic searches of PubMed,Web of Science,EMbase,the Cochrane Library,CNKI,WanFang Data,VIP,and CBM databases were conducted to collect predictive studies on microRNAs for STEMI prognosis.The search time limit was set from inception to October 31,2023.The quality of the literature was assessed according to the quality assessment of diagnostic accuracy studies-2(QUADAS-2).Meta-analysis was performed using Stata 17.0,RevMan 5.4 and Meta-Disc 1.4 software.Results:A total of 14 domestic and foreign studies were included in this study,involving 1 816 STEMI patients,of which 593 were detected as adverse prognosis.The random-effects model results showed that serum microRNAs had a pooled sensitivity of 0.78(95％CI:0.75-0.82)and a pooled specificity of 0.77(95％CI:0.75-0.79)for predicting adverse prognosis in STEMI patients,with an area under the summary receiver operating characteristic curve of 0.85(95％CI:0.83-0.88).Subgroup analysis suggested that different prognostic events,whether the patients were acute STEMI,and different sample sizes might be the sources of heterogeneity.Deek's funnel plot asymmetry test indicated no potential publication bias(t=1.10,P=0.29).Fagan's nomogram showed that the pre-test probability of adverse prognosis in STEMI patients was 50％,and after applying serum microRNAs,the probability of correctly predicting adverse prognosis events in STEMI patients increased from 50％to 78％,while the probability of misjudging good prognosis patients decreased from 50％to 21％.Conclusions:This study used a meta-analysis method to include 14 articles,and found that serum microRNAs had a certain predictive value for adverse prognosis in STEMI patients.
维普
万方数据