Admission Cardiac Troponins Predict Hospital Mortality in Type a Acute Aortic Dissection: a Meta-Analysis of Adjusted Risk Estimates

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.sup.2]=29.81%). Elevated troponins on admission are independently associated with increased in-hospital mortality in type A AAD. Key words: Troponin; Aortic dissection; Mortality; Meta-analysis