Purpose: Among the large numbers of clinical and laboratory markers predictors of adverse events for patients with stable angina, no data have been reported to appraise those more related to prognosis, to allow physicians a tailored follow up and management. We searched published literature to extract more powerful predictors of prgnosis in stable coronary disease patients. Methods: Medline and PubMed were systematically searched for eligible studies published up to 2013, reporting multivariate predictors of cardiovascular events (death, acute myocardial infarction, stroke and need for revascularization) in patients with stable angina. Study features, patient characteristics, and prevalence and predictors of such events were abstracted and pooled with random-effect methods (95% CIs). Results: 39 studies (101551 patients) were included. After a median follow-up of 57 months, cardiovascular events occurred in in 7.8% (95% CI 6.0% to 9.6%). Age, male sex (OR 1,28 95% CI 1,13 - 3,4), low EF (OR 8,53 95% CI 1,9 - 16,84), diabetes (OR 1,93 95% CI 1,1 - 11,2), prior myocardial infarction (OR 2,06 95% CI 1,4 - 5,64) and C-reactive protein (OR 1,67 95% CI 1,21 - 6,41) were the most powerful predictors of cardiovascular events. Conclusions: This meta-analysis demonstrated that simple and low-cost clinical features may help clinicians in identifying the most appropriate diagnostic and therapeutic approaches within the broad range of outpatients presenting with stable coronary artery disease.
Assessing risk in stable coronary disease patients: when should we intensify cares and follow-up? Results from a meta-analysis of observational studies
BARBERO, Umberto;D'ASCENZO, FABRIZIO;GAITA, Fiorenzo
2014-01-01
Abstract
Purpose: Among the large numbers of clinical and laboratory markers predictors of adverse events for patients with stable angina, no data have been reported to appraise those more related to prognosis, to allow physicians a tailored follow up and management. We searched published literature to extract more powerful predictors of prgnosis in stable coronary disease patients. Methods: Medline and PubMed were systematically searched for eligible studies published up to 2013, reporting multivariate predictors of cardiovascular events (death, acute myocardial infarction, stroke and need for revascularization) in patients with stable angina. Study features, patient characteristics, and prevalence and predictors of such events were abstracted and pooled with random-effect methods (95% CIs). Results: 39 studies (101551 patients) were included. After a median follow-up of 57 months, cardiovascular events occurred in in 7.8% (95% CI 6.0% to 9.6%). Age, male sex (OR 1,28 95% CI 1,13 - 3,4), low EF (OR 8,53 95% CI 1,9 - 16,84), diabetes (OR 1,93 95% CI 1,1 - 11,2), prior myocardial infarction (OR 2,06 95% CI 1,4 - 5,64) and C-reactive protein (OR 1,67 95% CI 1,21 - 6,41) were the most powerful predictors of cardiovascular events. Conclusions: This meta-analysis demonstrated that simple and low-cost clinical features may help clinicians in identifying the most appropriate diagnostic and therapeutic approaches within the broad range of outpatients presenting with stable coronary artery disease.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
